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VAERS Report 2156849

Case Report Section

Vaer Report Details

Age: NA

Gender: Female

State: Outside US

Patient Died?
No
Vaccine information

Name: COVID19 (COVID19 (PFIZER-BIONTECH))

Type: Coronavirus 2019 vaccine

Manufacturer: PFIZER

Lot: fn5254


Date report was received
2022-03-04
Date form completed
Date Vaccinated
2022-01-20
Date of Onset
0
Number of days (onset date – vaccination date)
0
Adverse Event Description

menstruation delayed; frequent headaches/frequent headaches in temples/forehead; insomnia/very disturbed sleep for 3 weeks; off label use; interchange of vaccine products; 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-202202191955022320-kt7ls. other case identifier(s): gb-mhra-adr 26626055. a 51 year-old female patient received bnt162b2 (comirnaty), administration date 20jan2022 (lot number: fn5254) as dose 2, single for covid-19 immunisation. relevant medical history included: "endometriosis" (unspecified if ongoing), notes: mild endometriosis; "covid-19", start date: 24jun2021 (unspecified if ongoing), notes: unsure when symptoms stopped; positive covid-19 test. the patient's concomitant medications were not reported. vaccination history included: covid-19 vaccine astrazeneca, administration date: 28mar2021, for covid-19 immunization. the following information was reported: off label use (medically significant) with onset 20jan2022, outcome "unknown", described as "off label use"; interchange of vaccine products (medically significant) with onset 20jan2022, outcome "unknown", described as "interchange of vaccine products"; headache (medically significant) with onset 21jan2022, outcome "not recovered", described as "frequent headaches/frequent headaches in temples/forehead"; insomnia (medically significant) with onset 21jan2022, outcome "recovering", described as "insomnia/very disturbed sleep for 3 weeks"; menstruation delayed (medically significant) with onset 01feb2022, outcome "not recovered", described as "menstruation delayed". the patient underwent the following laboratory tests and procedures: sars-cov-2 test: (25jun2021) yes - positive covid-19 test. no follow-up attempts are possible. no further information is expected

Lab Data
test date: 20210625; test name: covid-19 virus test; result unstructured data: test result:yes - positive covid-19 test
List of symptoms
headache insomnia interchange of vaccine products sars-cov-2 test off label use menstruation delayed
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