VAERS ID: 993136

AGE: 52| SEX: M|STATE: CA (United States)

Description

On the evening following COVID-19 vaccine, patient had mild fever and experienced mild epigastric and bilateral upper quadrant pain. Pain continued and patient presented to the ED on 1/31/2021 with epigastric pain. Final diagnosis appears to be acute diverticulitis with microperforation and early abscess formation. No physician notes document that the two events are related; however timing is close. Patient does not have a history of gallbladder disease, abdominal disease, etc. Patient is currently admitted and followed by general surgeon.

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Symptoms

Pyrexia, Abscess, Intestinal perforation, Abdominal pain upper, Diverticulitis

Vaccines

VAX DATE: 01-27-2021| ONSET DATE: 01-31-2021| DAYS TO ONSET: 4
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 2 COVID19 PFIZER\BIONTECH EL3249 IM LA

RECVDATE:02-02-2021
RPT_DATE:
CAGE_YR:52
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:
HOSPITAL:Y
HOSPDAYS:2
X_STAY:U
DISABLE:U
RECOVD:N
LAB_DATA:
V_ADMINBY:PVT
OTHER_MEDS:Multivitamin; Fish Oil
CUR_ILL:None known.
HISTORY:None known.
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:02-02-2021
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:Y
ALLERGIES:No Known Drug Allergies
V_FUNDBY:

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