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This is VAERS ID 1320374

History of Changes from the VAERS Wayback Machine

First Appeared on 5/21/2021

VAERS ID: 1320374
VAERS Form:2
Age:32.0
Sex:Male
Location:New Jersey
Vaccinated:2021-04-09
Onset:2021-05-02
Submitted:0000-00-00
Entered:2021-05-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6207 / 2 LA / -

Administered by: Unknown      Purchased by: ??
Symptoms: Appendicitis, SARS-CoV-2 test negative

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Splenomegaly
Allergies:
Diagnostic Lab Data: Test Date: 20210506; Test Name: covid test; Test Result: Negative
CDC 'Split Type': USPFIZER INC2021523854

Write-up: APPENDICITIS DIAGNOSED 5/6/21 WITH ONSET OF SYMPTOMS 5/2/21; This is a spontaneous report from a contactable consumer (patient). A 32-years-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 2 via an unspecified route of administration, administered in Arm Left on 09Apr2021 at the age of 32-years-old (Batch/Lot Number: EN6207) as 2ND DOSE, SINGLE for covid-19 immunisation. Medical history included splenomegaly from an unknown date. Patient did not have known allergies. There were no concomitant medications. The patient previously received first dose BNT162B2 administered in Arm Left on 22Mar2021 at the age of 32-years-old (Batch/Lot Number: EP7534) for covid-19 immunisation. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Prior to vaccination, the patient was not diagnosed with COVID-19. The patient experienced appendicitis diagnosed 06May2021 with onset of symptoms 02May2021. The event was reported as serious due to hospitalization (days for hospitalization was 1 day), life threatening. It resulted in Emergency room/department or urgent care. Treatment received for the adverse event included laparoscopic appendectomy. The patient underwent lab tests and procedures which included sars-cov-2 test negative: negative on 06May2021. The outcome of the event was resolving. Information about batch no/lot no cannot be obtained.


Record is removed as of 6/18/2021

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