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VAERS Report 2156829

Case Report Section

Vaer Report Details

Age: 12 years old

Gender: Male

State: Outside US

Patient Died?
No
Vaccine information

Name: COVID19 (COVID19 (PFIZER-BIONTECH))

Type: Coronavirus 2019 vaccine

Manufacturer: PFIZER

Lot: fl9994


Date report was received
2022-03-04
Date form completed
Date Vaccinated
2022-02-16
Date of Onset
0
Number of days (onset date – vaccination date)
0
Adverse Event Description

axillary lump; armpit pain; fatigue; inappropriate schedule of vaccine administered; 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-202202181552298920-gecl7 (ra). other case identifier(s): gb-mhra-adr 26621346 (ra). a 12 year-old male patient received bnt162b2 (comirnaty), administration date 16feb2022 (lot number: fl9994) at the age of 12 years as dose 2, single for covid-19 immunisation. relevant medical history included: "benign hypermobility" (unspecified if ongoing). patient has not had symptoms associated with covid-19. not had a covid-19 test. patient is not enrolled in clinical trial. the patient's concomitant medications were not reported. vaccination history included: comirnaty (dose 1), administration date: 18nov2021, for covid-19 immunization. the following information was reported: axillary mass (medically significant) with onset 18feb2022, outcome "not recovered", described as "axillary lump"; axillary pain (medically significant) with onset 18feb2022, outcome "not recovered", described as "armpit pain"; fatigue (medically significant) with onset 16feb2022, outcome "not recovered", described as "fatigue"; inappropriate schedule of product administration (non-serious) with onset 16feb2022, outcome "unknown", described as "inappropriate schedule of vaccine administered". the report does not relate to possible inflammation of the hear (myocarditis or pericarditis). patient has not tested positive for covid-19 since having the vaccine. no follow-up attempts are possible. no further information is expected

Lab Data
na
List of symptoms
fatigue axillary pain inappropriate schedule of product administration axillary mass
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