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This is VAERS ID 916710

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History of Changes from the VAERS Wayback Machine

First Appeared on 1/7/2021

VAERS ID: 916710
VAERS Form:2
Age:23.0
Sex:Female
Location:Missouri
Vaccinated:2020-12-29
Onset:2021-01-01
Submitted:0000-00-00
Entered:2021-01-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Appendicitis, Surgery, White blood cell count increased, Band neutrophil percentage increased

Life Threatening? Yes
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: 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)


Changed on 5/7/2021

VAERS ID: 916710 Before After
VAERS Form:2
Age:23.0
Sex:Female
Location:Missouri
Vaccinated:2020-12-29
Onset:2021-01-01
Submitted:0000-00-00
Entered:2021-01-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Appendicitis, Surgery, White blood cell count increased, Band neutrophil percentage increased

Life Threatening? Yes
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: Synthroid
Current Illness:
Preexisting Conditions: Hypothyroidism
Allergies: NKDA 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)


Changed on 5/14/2021

VAERS ID: 916710 Before After
VAERS Form:2
Age:23.0
Sex:Female
Location:Missouri
Vaccinated:2020-12-29
Onset:2021-01-01
Submitted:0000-00-00
Entered:2021-01-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Appendicitis, Surgery, White blood cell count increased, Band neutrophil percentage increased

Life Threatening? Yes
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: Synthroid
Current Illness:
Preexisting Conditions: Hypothyroidism
Allergies: NKDA 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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