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From the 10/15/2021 release of VAERS data:

This is VAERS ID 1178409



Case Details

VAERS ID: 1178409 (history)  
Form: Version 2.0  
Age: 27.0  
Sex: Male  
Location: Missouri  
Vaccinated:2021-04-07
Onset:2021-04-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 042A21A / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain, Computerised tomogram
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: No other illnesses at the time
Preexisting Conditions: None
Allergies: NKDA
Diagnostic Lab Data: CT 4/7/2021
CDC Split Type:

Write-up: Patient got home after vaccination and said he was having abdominal cramping. He is getting a CT at the hospital and will report results


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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1178409

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