Report #2893499

Received Apr 21, 2026

Life-threateningER / ED visitOffice visit

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Overview

Sex: Male
Age: 70 yrs
State: CO
Recovered: Recovered
Vaccinated: Sep 11, 2025
Onset: Sep 13, 2025
Days to onset: 2
Hospital days: —

Vaccines (1)

Type	Name	Manufacturer	Dose	Lot	Route / Site
VARZOS	ZOSTER (SHINGRIX)	GLAXOSMITHKLINE BIOLOGICALS	2	g2ha7	IM / LA

Symptoms (2)

Deep vein thrombosisProthrombin level normal

Symptom narrative

Pt contracted a blood clot (DVT) 2 days post vaccination.

Current illness

unknown

Medical history

unknown

Other medications

Omeprazole. Full list unknown

Allergies

No known allergies

Lab data

Clotting factors tests appeared normal. pt received Eliquis for 6 months due to clot