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From the 9/10/2021 release of VAERS data:

This is VAERS ID 1369970



Case Details

VAERS ID: 1369970 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0178 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Abdominal pain
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: PATIENT DOES NOT FILL AT OUR PHARMACY
Current Illness: NONE
Preexisting Conditions: NONE KNOWN
Allergies: NONE REPORTED
Diagnostic Lab Data: UNKNOWN
CDC Split Type:

Write-up: PATIENT WAS FINE WHEN HE LEFT THE PHARMACY. HE CALLED ABOUT AN HOUR LATER STATING THAT HE HAD SEVERE ABDOMINAL PAINS SUCH THAT HE COULD ONLY STAY ON HIS HANDS AND KNEES WITHOUT MAJOR DISCOMFORT. TRIED APAP AND NAUSEA MEDICATION AND THAT DID NOT WORK. HE CALLED BACK 2 HOURS LATER STATING THAT HIS CONDITION WAS NOT ANY BETTER. I ADVISED THAT HE MAKE HIS WAY INTO THE ER.


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