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From the 11/19/2021 release of VAERS data:

This is VAERS ID 916710

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Case Details

VAERS ID: 916710 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Female  
Location: Missouri  
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-01-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Private       Purchased by: ?
Symptoms: Appendicitis, Band neutrophil percentage increased, Surgery, White blood cell count increased
SMQs:, Neuroleptic malignant syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Synthroid
Current Illness:
Preexisting Conditions: Hypothyroidism
Allergies: NKDA
Diagnostic Lab Data: WBCs 13k, 4% Bands, CT with acute appendicitis- taken to surgery
CDC Split Type:

Write-up: Acute appendicitis, onset morning of 1/1/2021 (Reporting this because Pfizer covid vaccine had 3-4x higher risk of appendicitis, although data not reported for Moderna covid vaccine)

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