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This is VAERS ID 918051

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History of Changes from the VAERS Wayback Machine

First Appeared on 1/7/2021

VAERS ID: 918051
VAERS Form:2
Age:33.0
Sex:Female
Location:New Jersey
Vaccinated:2020-12-30
Onset:2021-01-01
Submitted:0000-00-00
Entered:2021-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026LZOA / 2 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Abdominal pain, Appendicectomy, Appendicitis, Ultrasound abdomen, Ultrasound pelvis, Computerised tomogram abdomen abnormal, Laboratory test, Liver function test

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)? Yes
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: prenatal vitamin
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a
Diagnostic Lab Data: Liver panel and chemistry lab: 1/1/21 Abdominal ultrasound: 1/1/21 Abdominal CT scan: 1/1/21 Pelvic Ultrasound: 1/2/21
CDC 'Split Type':

Write-up: At around 40 hours post vaccination, developed severe abdominal pain and went to an emergency room for evaluation on 1/1/21. Abdominal pain was eventually diagnosed as appendicitis requiring appendectomy on 1/2/21. Emergency room visit and hospital discharged patient early on 1/2/21. It was then determined that the on-call team covering mis-read the CT scan and acute appendicitis was found. Patient then went to Medical Center on 1/2/21 for appendectomy and was discharged later that night following operation.


Changed on 5/7/2021

VAERS ID: 918051 Before After
VAERS Form:2
Age:33.0
Sex:Female
Location:New Jersey
Vaccinated:2020-12-30
Onset:2021-01-01
Submitted:0000-00-00
Entered:2021-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026LZOA / 2 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Abdominal pain, Appendicectomy, Appendicitis, Ultrasound abdomen, Ultrasound pelvis, Computerised tomogram abdomen abnormal, Laboratory test, Liver function test

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)? Yes
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: prenatal vitamin
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a n/a
Diagnostic Lab Data: Liver panel and chemistry lab: 1/1/21 Abdominal ultrasound: 1/1/21 Abdominal CT scan: 1/1/21 Pelvic Ultrasound: 1/2/21
CDC 'Split Type':

Write-up: At around 40 hours post vaccination, developed severe abdominal pain and went to an emergency room for evaluation on 1/1/21. Abdominal pain was eventually diagnosed as appendicitis requiring appendectomy on 1/2/21. Emergency room visit and hospital discharged patient early on 1/2/21. It was then determined that the on-call team covering mis-read the CT scan and acute appendicitis was found. Patient then went to Medical Center on 1/2/21 for appendectomy and was discharged later that night following operation.


Changed on 5/14/2021

VAERS ID: 918051 Before After
VAERS Form:2
Age:33.0
Sex:Female
Location:New Jersey
Vaccinated:2020-12-30
Onset:2021-01-01
Submitted:0000-00-00
Entered:2021-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026LZOA / 2 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Abdominal pain, Appendicectomy, Appendicitis, Ultrasound abdomen, Ultrasound pelvis, Computerised tomogram abdomen abnormal, Laboratory test, Liver function test

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)? Yes
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: prenatal vitamin
Current Illness: n/a
Preexisting Conditions: n/a
Allergies: n/a n/a
Diagnostic Lab Data: Liver panel and chemistry lab: 1/1/21 Abdominal ultrasound: 1/1/21 Abdominal CT scan: 1/1/21 Pelvic Ultrasound: 1/2/21
CDC 'Split Type':

Write-up: At around 40 hours post vaccination, developed severe abdominal pain and went to an emergency room for evaluation on 1/1/21. Abdominal pain was eventually diagnosed as appendicitis requiring appendectomy on 1/2/21. Emergency room visit and hospital discharged patient early on 1/2/21. It was then determined that the on-call team covering mis-read the CT scan and acute appendicitis was found. Patient then went to Medical Center on 1/2/21 for appendectomy and was discharged later that night following operation.

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