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This is VAERS ID 1433669

History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1433669
VAERS Form:2
Age:60.0
Sex:Male
Location:Michigan
Vaccinated:2021-03-19
Onset:2021-06-21
Submitted:0000-00-00
Entered:2021-06-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 044A21A / 2 - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Abdominal pain upper, Pancreatitis, SARS-CoV-2 test positive, Asymptomatic COVID-19

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: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lamictal, losartan, metoprolol tartrate, multivitamin, prilosec, viagra, B1
Current Illness: None.
Preexisting Conditions: peptic ulcer disease, bipolar disorder, hypertension, tinnitus, migraine, hepatic steatosis, GERD, obesity
Allergies: Penicillins
Diagnostic Lab Data: COVID detected PCR on 06/21/21.
CDC 'Split Type':

Write-up: Fully vaccinated patient admitted to hospital with diagnosis of COVID per PCR. Patient admitted to the hospital on 06/21/21 for left sided upped abdominal pain. Diagnosed with pancreatitis. During admission testing patient has a detected PCR test for COVID. Patient remained asymptomatic for COVID throughout his stay. Discharged on 06/23/2021.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1433669&WAYBACKHISTORY=ON


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