Report #2867543

Received Oct 22, 2025

Life-threateningHospitalizedER / ED visitDisabled

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Overview

Sex: Female
Age: 37 yrs
State: MI
Recovered: Recovered
Vaccinated: Oct 10, 2025
Onset: Oct 10, 2025
Days to onset: 0
Hospital days: 1

Vaccines (2)

Type	Name	Manufacturer	Dose	Lot	Route / Site
COVID19	COVID19 (COVID19 (PFIZER-BIONTECH))	PFIZER\BIONTECH	N/A	NA0738	IM / LA
FLU3	INFLUENZA (SEASONAL) (FLUZONE)	SANOFI PASTEUR	N/A	UT8852JA	IM / RA

Symptoms (6)

AppendicectomyDiarrhoeaGastrointestinal disorderImaging procedureLaboratory testMalaise

Symptom narrative

Patient came into the Wellness Center for influenza and COVID 19 vaccinations on 10/10/2025 at 0916AM. She reports " I felt yucky Friday evening, Saturday morning I had diarrhea, and slowly my stomach got worse and worse! I went to ER at 1030 and had an emergency appendectomy at 2 in the morning! They said it was 18cm or mm? I?m not sure supposed to be 1-4 and it was 18 and ready to burst!"

Current illness

None

Medical history

None

Other medications

no known medications

Allergies

NKDA

Lab data

I do not have access to her medical record but labs, radiology, and surgery followed the vaccinations. For Item 21 I marked risk of death as that is a risk if she did not get treatment and appendix did rupture. I also marked for permanent damage as she required an appendectomy which is permanent loss of the organ with scaring. Unknown if this took place in (withheld city, state) or (withheld city, state).