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VAERS Report 2115817

Case Report Section

Détails du rapport Vaer

Âge: 13 ans

Genre: Female

Région : South Carolina

Patient décédé?
Non
Renseignements sur les vaccins

Nom: COVID19 (COVID19 (PFIZER-BIONTECH))

Type : Coronavirus 2019 vaccine

Fabricant: PFIZER

Lot: unknown


Date de réception du rapport
2022-02-16
Date à laquelle le formulaire est complèté
Date de vaccination
2021-09-13
Date d’apparition
0
Nombre de jours (date d’apparition – date de vaccination)
0
Description de l’événement indésirable

cough; fever; chills; this is a spontaneous report received from a contactable reporter(s) (consumer or other non hcp). the reporter is the patient. a 13 year-old female patient (not pregnant) received bnt162b2 (bnt162b2), administered in arm left, administration date 13sep2021 17:00 (batch/lot number: unknown) at the age of 13 years as dose 2, single for covid-19 immunisation. relevant medical history included: "asthma" (unspecified if ongoing). concomitant medication(s) included: zinc; vitamin c plus [ascorbic acid]; zyrtec [cetirizine hydrochloride]. vaccination history included: bnt162b2 (product=covid 19, brand=pfizer, lot unknown=true, lot unknown reason=not available/provided to reporter at the time of report completion, dose 1, single), for covid-19 immunization. the following information was reported: cough (non-serious) with onset 13sep2021 13:00, outcome "unknown", described as "cough"; pyrexia (non-serious) with onset 13sep2021 13:00, outcome "unknown", described as "fever"; chills (non-serious) with onset 13sep2021 13:00, outcome "unknown", described as "chills". therapeutic measures were not taken as a result of cough, pyrexia, chills. additional information: no covid prior vaccination. no covid tested post vaccination. no other vaccine in four weeks. no follow-up attempts are possible. no further information is expected

Données de laboratoire
na
Liste des symptômes
chills cough pyrexia
Patient décédé?
Non
Date de décès
N/A
Anomalie congénitale
false
Vaccin administré par :
Pharmacy or store
Vaccin acheté par :
Inconnu
Visite d’un patient à l’urgence?
Non
Patient hospitalisé?
Non
Séjour à l’hôpital
Non
Nombre de jours à l’hôpital
Non spécifié
Invalidité permanente?
Non
Allergies:
na
Maladie actuelle
na