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VAERS Report 2156859

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
2022-02-18
Date of Onset
0
Number of days (onset date – vaccination date)
0
Adverse Event Description

primary immunisation: non-pfizer vaccine; booster: comirnaty; primary immunisation: non-pfizer vaccine; booster: comirnaty; jaw pain; pain all over; pain in injection site; this is a spontaneous report received from a contactable reporter (consumer or other non hcp) from the regulatory agency. regulatory number: gb-mhra-webcovid-202202210842162290-xjzme. other case identifier(s): gb-mhra-adr 26627956. a female patient received bnt162b2 (comirnaty), administration date 18feb2022 (batch/lot number: unknown) as dose 3 (booster), single for covid-19 immunisation. relevant medical history included: "immunodeficiency" (unspecified if ongoing), notes: has an illness or condition, not listed above, which reduces the immune response (e.g, immunodeficiency); "coeliac" (unspecified if ongoing). patient has not had symptoms associated with covid-19. patient is not enrolled in clinical trial. concomitant medication(s) included: mercilon taken for contraception, start date: 06jul2018. vaccination history included: covid-19 vaccine (dose 1, manufacturer unknown, non-pfizer), for covid-19 immunisation; covid-19 vaccine (dose 2, manufacturer unknown, non-pfizer), for covid-19 immunisation. the following information was reported: off label use (medically significant), interchange of vaccine products (medically significant) all with onset 18feb2022, outcome "unknown" and all described as "primary immunisation: non-pfizer vaccine; booster: comirnaty"; pain in jaw (medically significant) with onset feb2022, outcome "not recovered", described as "jaw pain"; pain (medically significant) with onset feb2022, outcome "unknown", described as "pain all over"; vaccination site pain (medically significant) with onset feb2022, outcome "unknown", described as "pain in injection site". the patient underwent the following laboratory tests and procedures: covid-19 virus test: no - negative covid-19 test. additional information: initially patient experienced pain all over. 4 days later pain in injection site and severe jaw pain. patient has not tested positive for covid-19 since having the vaccine. no follow-up attempts are possible; information about lot/batch number cannot be obtained. no further information is expected

Lab Data
test name: covid-19 virus test; result unstructured data: test result:no - negative covid-19 test
List of symptoms
pain interchange of vaccine products pain in jaw sars-cov-2 test vaccination site pain 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?
No
Stay in hospital
No
Days in hospital
Unspecified
Permanent disability?
No
Allergies:
na
Current Illness
na