VAERS ID: 2258480

AGE: 67| SEX: F|STATE: CA

Description

April 19, 2022 (~ 2:30pm) received Moderna Booster shot . Typical malaise experienced for ~ 24 hours. April 21, 2022 (11:30am) abdominal pain began on right side of abdomen. Over the counter Beano and Peptobismol taken. Warm compresses given. Pain continued and intensified. At 3pm went to ER. Lab work drawn. CT scan done at 6-6:30pm. Results showed Acute Appendicitis. Emergency surgery done at ~ 8:30pm.

Symptoms

Abdominal pain, Appendicectomy, Appendicitis, Blood culture, Blood test, Computerised tomogram abdomen abnormal, Full blood count, Malaise, Urine analysis, White blood cell count increased

Vaccines

VAX DATE: 04-19-2022| ONSET DATE: 04-21-2022| DAYS TO ONSET: 2
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (MODERNA)) 4 COVID19 MODERNA 005m2114 SYR LA

RECVDATE:04-29-2022
RPT_DATE:
CAGE_YR:67
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:Y
ER_VISIT:U
HOSPITAL:Y
HOSPDAYS:1
X_STAY:U
DISABLE:U
RECOVD:U
LAB_DATA:I do not know the complete list of blood tests done. CBC, blood cultures from 2 sites, UA. Per NP, WBC was elevated CT scan: report showed appendicitis
V_ADMINBY:PVT
OTHER_MEDS:Furosemide
CUR_ILL:None
HISTORY:Lower extremity poor circulation Previous Back Surgery
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:2
TODAYS_DATE:04-29-2022
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:Y
ALLERGIES:No known allergies
V_FUNDBY:

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