Détails du rapport Vaer
Âge: N/A
Genre: Male
Région : Outside US
- Patient décédé?
- Non
- Renseignements sur les vaccins
-
Nom: COVID19 (COVID19 (PFIZER-BIONTECH))
Type : Coronavirus 2019 vaccine
Fabricant: PFIZER
Lot: fk9413
- Date de réception du rapport
- 2022-03-04
- Date à laquelle le formulaire est complèté
- Date de vaccination
- 2021-11-20
- Date d’apparition
- 0
- Nombre de jours (date d’apparition – date de vaccination)
- 0
- Description de l’événement indésirable
-
hair loss; off label use; interchange of vaccine products; this is a spontaneous report received from a contactable reporter(s) (pharmacist) from the regulatory authority(ra). regulatory number: gb-mhra-webcovid-202202171617407840-3wazm (ra). other case identifier(s): gb-mhra-adr 26614055 (ra). a 73-year-old male patient received bnt162b2 (comirnaty), administration date 20nov2021 (lot number: fk9413) as dose 3 (booster), single for covid-19 immunisation. relevant medical history included: "osteoarthritis" (unspecified if ongoing); "hypertension" (unspecified if ongoing); "high cholesterol" (unspecified if ongoing). the patient's concomitant medications were not reported. vaccination history included: covid-19 vaccine astrazeneca (dose number unknown, single), administration date: 02jul2021, for covid-19 immunisation; covid-19 vaccine (dose number unknown, manufacturer unknown), for covid-19 immunisation. the following information was reported: off label use (disability) with onset 20nov2021, described as "off label use"; interchange of vaccine products (disability) with onset 20nov2021, described as "interchange of vaccine products"; alopecia (disability) with onset 30nov2021, outcome "not recovered", described as "hair loss". the patient underwent the following laboratory tests and procedures: sars-cov-2 test: negative, notes: no - negative covid-19 test. clinical course: patient has not had symptoms associated with covid-19. patient has not tested positive for covid-19 since having the vaccine. patient is not enrolled in clinical trial. the report does not relate to possible blood clots or low platelet counts or to possible myocarditis or pericarditis. no follow-up attempts are possible. no further information is expected
- Données de laboratoire
-
test name: covid-19 virus test; test result: negative ; comments: no - negative covid-19 test
- Liste des symptômes
-
alopecia interchange of vaccine products sars-cov-2 test off label use
- Patient décédé?
- Non
- Date de décès
- N/A
- Anomalie congénitale
- false
- Vaccin administré par :
- Other
- 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?
- Oui
- Allergies:
-
na
- Maladie actuelle
-
na