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VAERS Report 2156821

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
2021-12-08
Date of Onset
0
Number of days (onset date – vaccination date)
0
Adverse Event Description

palpitations; breath shortness; chest pain; primary immunisation: non-pfizer vaccine; booster: comirnaty; primary immunisation: non-pfizer vaccine; booster: comirnaty; this is a spontaneous report received from a contactable reporter(s) (consumer or other non hcp) from the regulatory agency (ra). regulatory number: gb-mhra-webcovid-202202180947254190-t06il (ra). other case identifier(s): gb-mhra-adr 26619113 (ra). a 56 year-old male patient received bnt162b2 (comirnaty), administration date 08dec2021 (batch/lot number: unknown) as dose 3 (booster), single for covid-19 immunisation. relevant medical history included: "non-smoker" (unspecified if ongoing). the patient had no other health problems and had an active lifestyle. the patient did not have symptoms associated with covid-19 and was not enrolled in clinical trial. the patient's concomitant medications were not reported. vaccination history included: covid 19 vaccine (dose 2; manufacturer unknown), for covid-19 immunisation; covid 19 vaccine (dose 1; manufacturer unknown), for covid-19 immunisation. the following information was reported: off label use (medically significant), interchange of vaccine products (medically significant) all with onset 08dec2021, outcome "unknown" and all described as "primary immunisation: non-pfizer vaccine; booster: comirnaty"; palpitations (medically significant) with onset 18dec2021, outcome "not recovered", described as "palpitations"; dyspnoea (medically significant) with onset 18dec2021, outcome "not recovered", described as "breath shortness"; chest pain (medically significant) with onset 18dec2021, outcome "not recovered", described as "chest pain". the events "palpitations", "breath shortness" and "chest pain" were evaluated at the physician office visit. the patient underwent the following laboratory tests and procedures: echocardiogram: (unspecified date) all clear; electrocardiogram: (unspecified date) all clear; electrocardiogram ambulatory: (unspecified date) all clear; sars-cov-2 test: (23dec2021) no - negative covid-19 test; x-ray: (unspecified date) all clear. the patient was advised from general practitioner (gp) to wait as symptoms likely would go in time. the patient had not been tested positive for covid-19 since having the vaccination. no follow-up attempts are possible; information about lot/batch number cannot be obtained. no further information is expected

Lab Data
test name: echocardiogram; result unstructured data: test result:all clear; test name: ecg; result unstructured data: test result:all clear; test name: ambulatory ecg; result unstructured data: test result:all clear; test date: 20211223; test name: covid-19 virus test; result unstructured data: test result:no - negative covid-19 test; test name: x-ray; result unstructured data: test result:all clear
List of symptoms
chest pain dyspnoea palpitations interchange of vaccine products electrocardiogram ambulatory electrocardiogram sars-cov-2 test echocardiogram x-ray 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?
No
Stay in hospital
No
Days in hospital
Unspecified
Permanent disability?
No
Allergies:
na
Current Illness
na