National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1692091

Government Disclaimer on use of this data

History of Changes from the VAERS Wayback Machine

First Appeared on 9/17/2021

VAERS ID: 1692091
VAERS Form:2
Age:43.0
Sex:Male
Location:Rhode Island
Vaccinated:2021-08-21
Onset:2021-08-23
Submitted:0000-00-00
Entered:2021-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK RA / -

Administered by: Other      Purchased by: ??
Symptoms: Abdominal pain, Computerised tomogram, Pancreatic disorder

Life Threatening? No
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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: OMEPRAZOLE
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Blood pressure high
Allergies:
Diagnostic Lab Data: Test Date: 20210823; Test Name: CAT scan; Result Unstructured Data: Test Result:inflamed pancreas; Comments: inflamed pancreas
CDC 'Split Type': USPFIZER INC202101103388

Write-up: Abdominal pain resulting in hospital visit. CAT scan showed inflamed pancreas; Abdominal pain resulting in hospital visit. CAT scan showed inflamed pancreas; This is a spontaneous report from a contactable consumer (reported for himself). A 43-years-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Solution for injection, Batch/Lot number was not reported), via an unspecified route of administration, administered in arm right on 21Aug2021 at 11:00 (at the age of 43-years-old) as dose number unknown, single for COVID-19 immunisation at Workplace clinic. Medical history included hypertension from an unknown date and unknown if ongoing. Concomitant medication(s) included omeprazole (OMEPRAZOLE), high blood pressure med and advanced, taken for an unspecified indication, start and stop date were not reported. The patient did not receive any other vaccines within four weeks prior to the vaccination. Prior to the vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. The patient previously received benadryl and experienced drug hypersensitivity, wellbutrin and experienced drug hypersensitivity. On 23Aug2021 at 07:00, the patient experienced abdominal pain resulting in hospital visit. cat scan showed inflamed pancreas. The event assessed as serious (hospitalization). The reporter stated the events result in Emergency room/department or urgent care visit. The patient underwent lab tests and procedures which included computerised tomogram: inflamed pancreas on 23Aug2021 (inflamed pancreas). Therapeutic measures were taken as a result of events included treatment with CAT scan, morphine, pancreatic diet. The outcome of the events was resolving. The lot number for the vaccine, BNT162B2, was not provided and will be requested during follow up.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1692091&WAYBACKHISTORY=ON


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166