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VAERS Report 2156877

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: fm3092


Date report was received
2022-03-04
Date form completed
Date Vaccinated
2022-02-19
Date of Onset
1
Number of days (onset date – vaccination date)
1
Adverse Event Description

headache; vomited; this is a spontaneous report received from a contactable reporter (consume) from the regulatory authority. regulatory number: gb-mhra-webcovid-202202231022169020-cq4wd. other case identifier(s): gb-mhra-adr 26639160. a 12 year-old female patient received bnt162b2 (comirnaty), administration date 19feb2022 (lot number: fm3092) as dose 1, single for covid-19 immunisation. relevant medical history included: "covid-19", start date: 16nov2021 (unspecified if ongoing). patient did not have symptoms associated with covid-19. patient was not enrolled in clinical trial. the patient's concomitant medications were not reported. the following information was reported: headache (medically significant) with onset 20feb2022, outcome "recovered" (20feb2022), described as "headache"; vomiting (medically significant) with onset 20feb2022, outcome "recovered" (20feb2022), described as "vomited". the patient underwent the following laboratory tests and procedures: sars-cov-2 test: (16nov2021) yes - positive covid-19 test. patient did not test positive for covid-19 since having the vaccine. the report was not related to possible inflammation of the heart (myocarditis or pericarditis). no follow-up attempts are possible. no further information is expected

Lab Data
test date: 20211116; test name: covid-19 virus test; result unstructured data: test result:yes - positive covid-19 test
List of symptoms
vomiting headache 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