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VAERS Report 2156890

Case Report Section

Détails du rapport Vaer

Âge: N/A

Genre: Male

Région : Outside US

Patient décédé?
Renseignements sur les vaccins


Type : Coronavirus 2019 vaccine

Fabricant: PFIZER

Lot: fg3712

Date de réception du rapport
Date à laquelle le formulaire est complèté
Date de vaccination
Date d’apparition
Nombre de jours (date d’apparition – date de vaccination)
Description de l’événement indésirable

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

Données de laboratoire
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
Liste des symptômes
myositis pain myocarditis polymerase chain reaction sars-cov-2 test sars-cov-2 antibody test
Patient décédé?
Date de décès
Anomalie congénitale
Vaccin administré par :
Vaccin acheté par :
Visite d’un patient à l’urgence?
Patient hospitalisé?
Séjour à l’hôpital
Nombre de jours à l’hôpital
Non spécifié
Invalidité permanente?
Maladie actuelle