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

This is VAERS ID 1212565



Case Details

VAERS ID: 1212565 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Massachusetts  
Vaccinated:2021-04-09
Onset:2021-04-14
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain, Coeliac artery stenosis, Computerised tomogram abdomen abnormal, Computerised tomogram pelvis abnormal, Splenic artery thrombosis, Splenic infarction
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), 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? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Developed acute severe abdominal pain and found to have splenic infarct, splenic artery thrombosis, celiac artery stenosis on morning of 4/14/2021 on CT abd/pelvis with IV contrast and presented to ED for symptoms. Started on apixaban.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1212565

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