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VAERS Report 2156822

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: fn3543


Date report was received
2022-03-04
Date form completed
Date Vaccinated
2021-12-18
Date of Onset
0
Number of days (onset date – vaccination date)
0
Adverse Event Description

insomnia; this is a spontaneous report received from a contactable reporter (consumer or other non hcp) from the regulatory agency (ra). regulatory number: gb-mhra-webcovid-202202181005523210-6hplq (ra). other case identifier(s): gb-mhra-adr 26619624 (ra). a male patient received bnt162b2 (comirnaty), administration date 18dec2021 (lot number: fn3543) as dose 3 (booster), single for covid-19 immunisation. the patient's relevant medical history and concomitant medications were not reported. the patient has not had symptoms associated with covid-19, has not tested positive for covid-19 since having the vaccine and is not enrolled in clinical trial. vaccination history included: covid-19 vaccine astrazeneca (dose 1), administration date: 29mar2021, for covid-19 vaccination; covid-19 vaccine astrazeneca (dose 2), administration date: 16jun2021, for covid-19 vaccination. the following information was reported: insomnia (hospitalization, medically significant) with onset 18dec2021, outcome "recovering", described as "insomnia"; however, it was also reported that the event resolved on 26jan2022. the patient underwent the following laboratory tests and procedures: covid-19 virus test: negative, notes: no - negative covid-19 test. no follow-up attempts are possible. no further information is expected

Lab Data
test name: covid-19 virus test; result unstructured data: test result:negative; comments: no - negative covid-19 test
List of symptoms
insomnia sars-cov-2 test
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