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VAERS Report 2156823

Case Report Section

Vaer Report Details

Age: 35 years old

Gender: Unknown

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

tachycardia; panic attacks; pins and needles; anxiety; vertigo; off label use; interchange of vaccine products; tinnitus; this is a spontaneous report received from a contactable reporter(s) (consumer or other non hcp) from the regulatory authority. regulatory number: gb-mhra-webcovid-202202181011463080-9mx7z (ra). a 35 year-old patient received bnt162b2 (comirnaty), administration date 18dec2021 (lot number: fn3543) at the age of 35 years as dose 3 (booster), single for covid-19 immunisation. the patient's relevant medical history and concomitant medications were not reported. 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: off label use (hospitalization, medically significant) with onset 18dec2021, outcome "unknown", described as "off label use"; interchange of vaccine products (hospitalization, medically significant) with onset 18dec2021, outcome "unknown", described as "interchange of vaccine products"; anxiety (hospitalization, medically significant) with onset 24dec2021, outcome "recovered with sequelae", described as "anxiety"; tachycardia (hospitalization, medically significant) with onset 25dec2021, outcome "recovering", described as "tachycardia"; panic attack (hospitalization, medically significant) with onset 25dec2021, outcome "recovering", described as "panic attacks"; paraesthesia (hospitalization, medically significant) with onset 24dec2021, outcome "recovered" (29dec2021), described as "pins and needles"; tinnitus (hospitalization, medically significant) with onset 18dec2021, outcome "not recovered", described as "tinnitus"; vertigo (hospitalization, medically significant) with onset 20dec2021, outcome "recovered with sequelae", described as "vertigo". the patient underwent the following laboratory tests and procedures: sars-cov-2 test: negative, notes: no - negative covid-19 test. additional information: patient has not had symptoms associated with covid-19. patient was not enrolled in clinical trial. 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
List of symptoms
anxiety paraesthesia tinnitus tachycardia vertigo interchange of vaccine products panic attack sars-cov-2 test 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?
Yes
Stay in hospital
No
Days in hospital
Unspecified
Permanent disability?
No
Allergies:
na
Current Illness
na