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This is VAERS ID 1333681

History of Changes from the VAERS Wayback Machine

First Appeared on 5/28/2021

VAERS ID: 1333681
VAERS Form:2
Age:50.0
Sex:Male
Location:Connecticut
Vaccinated:2021-04-22
Onset:2021-05-02
Submitted:0000-00-00
Entered:2021-05-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0170 / 2 RA / IM

Administered by: Public      Purchased by: ??
Symptoms: Abdominal pain upper, Blood potassium normal, Blood sodium normal, Blood triglycerides normal, Haematocrit increased, Haemoglobin increased, Neutrophil count normal, Pancreatic injury, Pancreatitis acute, Platelet count normal, White blood cell count increased, Imaging procedure abnormal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations: Tetanus, unknown reaction
Other Medications: ? OTC antacids
Current Illness: none
Preexisting Conditions: esophageal reflux
Allergies: Penicillins; Tetanus vaccine
Diagnostic Lab Data: Recent Labs Lab 05/02/21 0815 WBC 10.5* HGB 18.1* HCT 53.2* PLT 289 Recent Labs Lab 05/02/21 0815 NEUTROPHILS 72.2 Recent Labs Lab 05/02/21 0815 05/03/21 0733 NA 142 138 K 4.0 4
CDC 'Split Type':

Write-up: Admit date: 5/2/2021 Age: 50 y.o. Discharge date: 5/4/2021 Discharged Condition: good Disposition: Home Principal Diagnosis: Acute pancreatitis without infection or necrosis Other Active Diagnoses: Present on Admission: o Acute pancreatitis without infection or necrosis Issues to be Addressed Post Discharge: 1. Referral to GI to review episode of pancreatitis, isolated episode with quick recovery, to review need for further evaluation 2. Follow-up with PCP for discharge follow-up

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