VAERS ID: 1794737

AGE: 14| SEX: M|STATE: SC (United States)

Description

Patient 14 yo, male, in excellent health. PFizer EWO178 vaccine dates (pharmacy near grandma's house ) were 6/4/21 & 6/25/21. He was hurting all week and on 7/7/21, he had an emergency appendectomy at hospital

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Symptoms

Pain, Appendicectomy

Vaccines

VAX DATE: 06-04-2021| ONSET DATE: 07-07-2021| DAYS TO ONSET: 33
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 1 COVID19 PFIZER\BIONTECH EWO178 SYR RA

RECVDATE:10-18-2021
RPT_DATE:
CAGE_YR:14
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:Y
ER_VISIT:
HOSPITAL:Y
HOSPDAYS:3
X_STAY:U
DISABLE:U
RECOVD:Y
LAB_DATA:7/7/21 - Initial eval at Medical Center w Dr. 7/7/21 - Healthcare 7/7/21 - Appendectomy was at hospital 7/11/21 - Hospital More pain. Follow up once we got him home from grandma's house.
V_ADMINBY:PHM
OTHER_MEDS:
CUR_ILL:
HISTORY:
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:10-18-2021
BIRTH_DEFECT:U
OFC_VISIT:Y
ER_ED_VISIT:Y
ALLERGIES:
V_FUNDBY:

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