VAERS ID: 1046403

AGE: 68| SEX: M|STATE: PR (United States)

Description

ABDOMINAL PAIN, PERFORATED BOWEL.

Open in Wayback Machine
(If this is a foreign report without a description you will be able to read the description in the Wayback Machine on Medalerts if the report became public for the first time before November 18, 2022.)

Symptoms

Abdominal pain, Intestinal perforation

Vaccines

VAX DATE: 01-18-2021| ONSET DATE: 01-23-2021| DAYS TO ONSET: 5
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 1 COVID19 PFIZER\BIONTECH EL 3246 IM LA

RECVDATE:02-22-2021
RPT_DATE:
CAGE_YR:68
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:
HOSPITAL:Y
HOSPDAYS:6
X_STAY:U
DISABLE:U
RECOVD:N
LAB_DATA:
V_ADMINBY:PVT
OTHER_MEDS:LISINOPRIL, NIFEDIPINE
CUR_ILL:NONE
HISTORY:COLITIS
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:02-22-2021
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:NONE
V_FUNDBY:

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