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VAERS Report 2156788

Case Report Section

Vaer Report Details

Age: NA

Gender: Male

State: Outside US

Patient Died?
No
Vaccine information

Name: COVID19 (COVID19 (PFIZER-BIONTECH))

Type: Coronavirus 2019 vaccine

Manufacturer: PFIZER

Lot: unknown


Date report was received
2022-03-04
Date form completed
Date Vaccinated
2021-11-29
Date of Onset
0
Number of days (onset date – vaccination date)
0
Adverse Event Description

lightheadedness; fatigue/unusual tiredness; heart palpitations; racing heart (tachycardia); headache fullness; chest pain; shortness of breath; off label use; interchange of vaccine product; this is a spontaneous report received from a contactable reporter(s) (consumer) from the regulatory agency (ra). regulatory number: gb-mhra-webcovid-202202170755441000-hbgby (ra). other case identifier(s): gb-mhra-adr 26612342 (ra). a 34-year-old male patient received bnt162b2 (comirnaty), administration date 29nov2021 (batch/lot number: unknown) as dose 3 (booster), single for covid-19 immunisation. the patient's relevant medical history and concomitant medications were not reported. vaccination history included: covid-19 vaccine (dose 1; manufracturer unknown), for covid-19 immunisation; covid-19 vaccine (dose 2; manufracturer unknown), for covid-19 immunisation. the following information was reported: off label use (hospitalization, medically significant) with onset 29nov2021, outcome "unknown", described as "off label use"; interchange of vaccine products (hospitalization, medically significant) with onset 29nov2021, outcome "unknown", described as "interchange of vaccine product"; dizziness (hospitalization, medically significant), outcome "unknown", described as "lightheadedness"; headache (hospitalization, medically significant) with onset 03jan2022, outcome "not recovered", described as "headache fullness"; chest pain (hospitalization, medically significant) with onset 03jan2022, outcome "not recovered", described as "chest pain"; dyspnoea (hospitalization, medically significant) with onset 03jan2022, outcome "not recovered", described as "shortness of breath"; fatigue (hospitalization, medically significant), outcome "unknown", described as "fatigue/unusual tiredness"; palpitations (hospitalization, medically significant), outcome "unknown", described as "heart palpitations"; tachycardia (hospitalization, medically significant), outcome "unknown", described as "racing heart (tachycardia)". the patient underwent the following laboratory tests and procedures: computerised tomogram: result unknown; sars-cov-2 test: negative, notes: no - negative covid-19 test. clinical course: the patient experienced constant headache for 8/9weeks now, lightheadedness, and shortness of breath. the patient was really struggling with life at the moment. patient has not tested positive for covid-19 since having the vaccine and is not enrolled in clinical trial. patient has not had symptoms associated with covid-19. this report relates to possible inflammation of the heart (myocarditis or pericarditis). diagnosis was not made by a medical professional. no follow-up attempts are possible; information about lot/batch number cannot be obtained. no further information is expected

Lab Data
test name: ct; result unstructured data: test result:result unknown; test name: covid-19 virus test; test result: negative ; comments: no - negative covid-19 test
List of symptoms
fatigue headache chest pain dizziness dyspnoea tachycardia palpitations interchange of vaccine products computerised tomogram sars-cov-2 test off label use
Patient Died?
No
Date Died
NA
Birth defect
false
Vaccine Administered By:
Other
Vaccine Purchased By:
Unknown
Patient visit ER?
No
Patient Hospitalized?
Yes
Stay in hospital
No
Days in hospital
Unspecified
Permanent disability?
No
Allergies:
na
Current Illness
na