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VAERS Report 2156811

Case Report Section

Détails du rapport Vaer

Âge: 55 ans

Genre: Male

Région : Outside US

Patient décédé?
Renseignements sur les vaccins


Type : Coronavirus 2019 vaccine

Fabricant: PFIZER

Lot: fk0596

Date de réception du rapport
Date à laquelle le formulaire est complèté
Date de vaccination
Date d’apparition
Nombre de jours (date d’apparition – date de vaccination)
Description de l’événement indésirable

off label use; interchange of vaccine products; heavy bleeding at time of vaccine; shoulder pain; this is a spontaneous report received from a contactable reporter(s) (consumer or other non hcp) from the regulatory agency. regulatory number: gb-mhra-webcovid-202202171800565610-4v5yu. other case identifier(s): gb-mhra-adr 26614632. a 55-year-old male patient received bnt162b2 (comirnaty), administration date 13nov2021 (lot number: fk0596) at the age of 55 years as dose 3 (booster), single for covid-19 immunization. the patient's relevant medical history and concomitant medications were not reported. vaccination history included: covid-19 vaccine (dose 1; manufactuerer unknown), for covid-19 immunization; covid-19 vaccine (dose 2; manufactuerer unknown), for covid-19 immunization. the patient experienced heavy bleeding at time of vaccine and sharp pain/shoulder pain. patient has not had symptoms associated with covid-19. the following information was reported: off label use (medically significant), outcome "unknown", described as "off label use"; interchange of vaccine products (medically significant), outcome "unknown", described as "interchange of vaccine products"; arthralgia (medically significant) with onset 13nov2021, outcome "not recovered", described as "shoulder pain"; haemorrhage (medically significant), outcome "unknown", described as "heavy bleeding at time of vaccine". the events "shoulder pain" and "heavy bleeding at time of vaccine" were evaluated at the physician office visit. the patient visited a gp and prescribed codeine and 'physio'. therapeutic measures were taken as a result of arthralgia which included codeine. the patient underwent the following laboratory tests and procedures: sars-cov-2 test: negative, notes: no - negative covid-19 test. patient has not tested positive for covid-19 since having the vaccine. patient is not enrolled in clinical trial. 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
arthralgia haemorrhage interchange of vaccine products sars-cov-2 test off label use
Patient décédé?
Date de décès
Anomalie congénitale
Vaccin administré par :
Vaccin acheté par :
Visite d’un patient à l’urgence?
Patient hospitalisé?
Séjour à l’hôpital
Nombre de jours à l’hôpital
Non spécifié
Invalidité permanente?
Maladie actuelle