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VAERS Report 2156890

Case Report Section

Vaer Report Details

Age: NA

Gender: Male

State: Outside US

Patient Died?
No
Vaccine information

Name: COVID19 (COVID19 (PFIZER-BIONTECH))

Type: Coronavirus 2019 vaccine

Manufacturer: PFIZER

Lot: fg3712


Date report was received
2022-03-04
Date form completed
Date Vaccinated
2021-09-22
Date of Onset
153
Number of days (onset date – vaccination date)
153
Adverse Event Description

myocarditis; myositis; pain localised/localised upper arm pain; this is a spontaneous report received from a contactable reporter(consumer) from the regulatory authority (ra). the reporter is the patient. regulatory number: gb-mhra-webcovid-202202232252255980-nk1ao. other case identifier(s): gb-mhra-adr 26643878. a 53 year-old male patient received bnt162b2 (comirnaty), administered in arm left, administration date 22sep2021 (lot number: fg3712) as dose 3 (booster), single for covid-19 immunisation. relevant medical history included: "suspected covid-19", start date: mar2020 (unspecified if ongoing), notes: lost sense of taste; unsure when symptoms started; unsure when symptoms stopped; "clinical trial participant" (unspecified if ongoing), notes: study details: panoramic (not started 1st dose yet); "hypertension" (unspecified if ongoing). concomitant medication(s) included: ramipril taken for hypertension, start date: 01oct2020. vaccination history included: bnt162b2 (dose 1, lot number: ee8492), administration date: 03jan2021, for covid-19 immunisation, reaction(s): "tenderness"; bnt162b2 (dose 2, lot number: ek4176), administration date: 15feb2021, for covid-19 immunisation, reaction(s): "tenderness", "inappropriate schedule of vaccine administered". the following information was reported: myocarditis (medically significant), outcome "not recovered", described as "myocarditis"; myositis (non-serious), outcome "not recovered", described as "myositis"; pain (non-serious) with onset 22feb2022, outcome "not recovered", described as "pain localised/localised upper arm pain". the patient underwent the following laboratory tests and procedures: polymerase chain reaction: (20feb2022) positive; sars-cov-2 antibody test: (15jul2020) positive, notes: retrospectively probably had 1st covid infection (very mild) in mar2020 (lost sense of taste) and 2nd more severe covid infection started 19feb2022; sars-cov-2 test: (15jul2020) positive. clinical course: patient experienced new onset (5 months after last vaccination) of localised upper arm pain and tenderness over site of previous pfizer covid vaccinations (x3: jan, feb and sep2021, all in same non dominant left side). this started on day 3 of a subsequent episode of covid infection and was mild. patient guess it was a local myositis flare reaction caused by immune response to antigen stuck in left arm. patient was wondering if he would get every time a get coronavirus infection forever more. it was also reported that the report was unrelated to possible inflammation of the heart (myocarditis or pericarditis). no follow-up attempts are possible. no further information is expected.; sender's comments: linked report(s) : gb-pfizer inc-202200340199 same patient, same product, different dose and different event (loe).;gb-pfizer inc-202200340197 same patient, same product, different dose and different event.;gb-pfizer inc-202200340198 same patient, same product, different dose and different event

Lab Data
test date: 20220220; test name: pcr; test result: positive ; test date: 20200715; test name: covid-19 antibody test; test result: positive ; comments: retrospectively probably had 1st covid infection (very mild) in mar2020 (lost sense of taste) and 2nd more severe covid infection started 19feb2022; test date: 20200715; test name: covid-19 virus test; test result: positive
List of symptoms
myositis pain myocarditis polymerase chain reaction sars-cov-2 test sars-cov-2 antibody 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