Adverse Event Reporting
| VAERS ID | 920628 |
|---|---|
| Gender | Female |
| Age | 63 |
| StateCode | NY |
| Pharmaceutical Company | PFIZER\BIONTECH |
| Lot Number | EL0142 |
| Number of vaccinations | 1 |
| Vaccinated | 2021-01-02 |
| Onset | 2021-01-02 |
| Condition | Hospitalized Life Threatening |
Symptoms
- Pain in extremity
- Pyrexia
- Chills
- Abdominal pain
- Computerised tomogram abdomen
- Computerised tomogram abnormal
- Colostomy
- Intestinal resection
- Large intestine perforation
Current Illness
Preexisting Conditions
pancreatic cysts colonic polyps last colonoscopy 9/2020 and one polyp removed ATM gene mutation hyperlipidemia DCIS of breast in 1/2015 s/p lumpectomy and xrt thyroid nodules vertigo
Other Medications
Tylenol 350 mg as needed Valium 5 mg as needed
Previous Vaccinations
Allergies
Compazine led to restless leg syndrome Penicillin anaphylaxis Sulfamethoxazole rash
Laboratory Data
CT scan of abdomen and pelvis 1/3/2021
Write-up
6-7 hours after the vaccine she developed arm pain, fever and chills.
About an hour later she started to have abdominal pain which worsened over the course of the day to excruciating.
She went to the Emergency Room where a CT scan revealed a perforation of her sigmoid colon and had a resection of the area of the colon and a diverting colostomy surgery done the evening of 1/3/2021.