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VAERS Report 2156785

Case Report Section

Vaer Report Details

Age: NA

Gender: Female

State: Outside US

Patient Died?
No
Vaccine information

Name: COVID19 (COVID19 (PFIZER-BIONTECH))

Type: Coronavirus 2019 vaccine

Manufacturer: PFIZER

Lot: fj5782


Date report was received
2022-03-04
Date form completed
Date Vaccinated
2021-09-27
Date of Onset
0
Number of days (onset date – vaccination date)
0
Adverse Event Description

palsy bells; dose 4; dose 4; this is a spontaneous report received from a contactable reporter(s) (physician) from the regulatory authority (ra). regulatory number: gb-mhra-webcovid-202202162339088240-vubzn (ra). other case identifier(s): gb-mhra-adr 26611796 (ra). a 44 year-old female patient (not pregnant) received bnt162b2 (comirnaty), administration date 27sep2021 (lot number: fj5782) as dose 4 (booster), single for covid-19 immunisation. relevant medical history included: "type 2 diabetes" (unspecified if ongoing), notes: type 2 diabetes patient has not had symptoms associated with covid-19 patient is not pregnant, patient is not currently breastfeeding. the patient's concomitant medications were not reported. vaccination history included: bnt162b2 (dose 1), administration date: 20dec2020, for covid-19 immunisation; bnt162b2 (dose 2), administration date: 07jan2021, for covid-19 immunisation; bnt162b2 (dose 3), administration date: 25mar2021, for covid-19 immunisation. the following information was reported: off label use (medically significant), immunisation (medically significant) all with onset 27sep2021, outcome "unknown" and all described as "dose 4"; bell's palsy (medically significant) with onset 11feb2022, outcome "not recovered", described as "palsy bells". the patient underwent the following laboratory tests and procedures: sars-cov-2 test: (13feb2022) negative, notes: no - negative covid-19 test; varicella zoster virus infection: (unspecified date) negative. clinical course: patient has not been tested positive for covid-19 since having the vaccine. unsure if patient was enrolled in clinical trial. this report did not relate to possible blood clots or low platelet counts and possible myocarditis or pericarditis. no follow-up attempts are possible. no further information is expected

Lab Data
test date: 20220213; test name: covid-19 virus test; test result: negative ; comments: no - negative covid-19 test; test name: vzv igm; test result: negative
List of symptoms
sars-cov-2 test immunisation varicella zoster virus infection off label use bell's palsy
Patient Died?
No
Date Died
NA
Birth defect
false
Vaccine Administered By:
Other
Vaccine Purchased By:
Unknown
Patient visit ER?
No
Patient Hospitalized?
No
Stay in hospital
No
Days in hospital
Unspecified
Permanent disability?
No
Allergies:
na
Current Illness
na