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From the 5/14/2021 release of VAERS data (an older release, current is 9/17/2021):

This is VAERS ID 1085536



Case Details

VAERS ID: 1085536 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-03-05
Onset:2021-03-07
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-03-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802070 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Abdominal pain, Appendicectomy, Appendicitis, Arthralgia, Blood test, Computerised tomogram, Fatigue, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: levothyroxine, potassium, metformin, flomax, tadalafil, invokana,
Current Illness: none
Preexisting Conditions: diabetes, thalassemia
Allergies: none
Diagnostic Lab Data: CT Scan, Bloodwork
CDC Split Type:

Write-up: Initially Fever, Fatigue, Joint Pain. 2 days later pain in right abdomen, diagnosed with Appendicitis and had emergency appendectomy performed.


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20210514&IDNUMBER=1085536


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