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VAERS Report 2156804

Case Report Section

Vaer Report Details

Age: 24 years old

Gender: Male

State: Outside US

Patient Died?
No
Vaccine information

Name: COVID19 (COVID19 (PFIZER-BIONTECH))

Type: Coronavirus 2019 vaccine

Manufacturer: PFIZER

Lot: fl9994


Date report was received
2022-03-04
Date form completed
Date Vaccinated
2022-02-10
Date of Onset
0
Number of days (onset date – vaccination date)
0
Adverse Event Description

fatigue; chest pain; myocarditis; this is a spontaneous report received from a contactable reporter(s) (other hcp) from the regulatory agency. regulatory number: gb-mhra-webcovid-202202171418412190-0g1cm. other case identifier(s): gb-mhra-adr 26613079. a 24 year-old male patient received bnt162b2 (comirnaty), administration date 10feb2022 (lot number: fl9994) at the age of 24 years as dose 3 (booster), single for covid-19 immunisation. the patient's relevant medical history was not reported. concomitant medication(s) included: colchicine. vaccination history included: bnt162b2 (dose 1), for covid-19 immunisation; bnt162b2 (dose 2), for covid-19 immunisation. the following information was reported: myocarditis (hospitalization, medically significant) with onset 10feb2022, outcome "recovering", described as "myocarditis"; fatigue (hospitalization, medically significant), outcome "unknown", described as "fatigue"; chest pain (hospitalization, medically significant), outcome "unknown", described as "chest pain". the events "myocarditis", "fatigue" and "chest pain" were evaluated at the physician office visit. the patient underwent the following laboratory tests and procedures: sars-cov-2 test: (unspecified date) negative, notes: no - negative covid-19 test; troponin: (16feb2022) 9012, notes: 9012. therapeutic measures were taken as a result of myocarditis, fatigue, chest pain. no follow-up attempts are possible. no further information is expected

Lab Data
test name: covid-19 virus test; test result: negative ; comments: no - negative covid-19 test; test date: 20220216; test name: troponin; result unstructured data: test result:9012; comments: 9012
List of symptoms
fatigue chest pain myocarditis sars-cov-2 test troponin
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