VAERS ID: 909720

AGE: 41| SEX: M|STATE: MN (United States)

Description

12/23- began to experience intermittent right lower quadrant pain in the morning, fever of 100.4 F in the evening which subsided with ibuprofen. 12/24- no fever noted but intermittent right lower quadrant pain continued, seen at the Health Clinic, sent to Hospital ER for CT scan, diagnosed with appendicitis, appendectomy performed.

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Symptoms

Pyrexia, Abdominal pain lower, Computerised tomogram abnormal, Appendicectomy, Appendicitis

Vaccines

VAX DATE: 12-22-2020| ONSET DATE: 12-23-2020| DAYS TO ONSET: 1
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 1 COVID19 PFIZER\BIONTECH EJ1685 IM LA

RECVDATE:12-27-2020
RPT_DATE:
CAGE_YR:41
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:Y
ER_VISIT:
HOSPITAL:Y
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:U
LAB_DATA:12/24- CT revealed appendicitis, appendectomy performed
V_ADMINBY:PVT
OTHER_MEDS:
CUR_ILL:
HISTORY:
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:12-27-2020
BIRTH_DEFECT:U
OFC_VISIT:Y
ER_ED_VISIT:Y
ALLERGIES:
V_FUNDBY:

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