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VAERS Report 2156856

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: unknown


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

sars-cov-2 infection; drug ineffective; this is a spontaneous report received from a contactable consumer from the regulatory authority. regulatory number: gb-mhra-webcovid-202202201935515420-lkkys. other case identifier(s): gb-mhra-adr 26626406. a female patient received bnt162b2 (pfizer-biontech covid-19 vaccine, lot number and expiration date were not reported), via an unspecified route of administration on 09nov2021 as dose 3 (booster) single, bnt162b2 (pfizer-biontech covid-19 vaccine, lot number and expiration date were not reported), via an unspecified route of administration on an unspecified date as dose 2, single and bnt162b2 (pfizer-biontech covid-19 vaccine, lot number and expiration date were not reported), via an unspecified route of administration on an unspecified date as dose 1, single for covid-19 immunization. the patient's relevant medical history and concomitant medications were not reported. the following information was reported: covid-19 (medically significant) with onset 03jan2022, outcome "recovered", described as "sars-cov-2 infection"; drug ineffective (medically significant) with onset 03jan2022, outcome "unknown", described as "drug ineffective". the patient underwent the following laboratory tests and procedures: sars-cov-2 test: (03jan2022) positive, notes: yes - positive covid-19 test. no follow-up attempts are possible; information about lot/batch number cannot be obtained. no further information is expected.; sender's comments: linked report(s) : gb-pfizer inc-202200307629 same patient same dose different event

Lab Data
test date: 20220103; test name: covid-19 virus test; test result: positive ; comments: yes - positive covid-19 test
List of symptoms
drug ineffective covid-19 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?
No
Stay in hospital
No
Days in hospital
Unspecified
Permanent disability?
No
Allergies:
na
Current Illness
na