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This is VAERS ID 909720

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History of Changes from the VAERS Wayback Machine

Color Schemes (Before/After):

First Appeared on 12/30/2020

VAERS ID: 909720
VAERS Form:2
Age:41.0
Sex:Male
Location:Minnesota
Vaccinated:2020-12-22
Onset:2020-12-23
Submitted:0000-00-00
Entered:2020-12-27
Vaccin­ation / Manu­facturer (1 vaccine) Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1685 / 1 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Abdominal pain lower, Appendicectomy, Appendicitis, Computerised tomogram abnormal, Pyrexia

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: (blank)
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: 12/24- CT revealed appendicitis, appendectomy performed
CDC 'Split Type':

Write-up: 12/23- began to experience intermittent right lower quadrant pain in the morning, fever of 100.4 F in the evening which subsided with ibuprofen. 12/24- no fever noted but intermittent right lower quadrant pain continued, seen at the Health Clinic, sent to Hospital ER for CT scan, diagnosed with appendicitis, appendectomy performed.

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