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VAERS Report 2156893

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: unknown


Date report was received
2022-03-04
Date form completed
Date Vaccinated
2022-02-15
Date of Onset
2
Number of days (onset date – vaccination date)
2
Adverse Event Description

flu like symptoms; this is a spontaneous report received from a contactable reporter (consumer) from the regulatory agency. regulatory number: gb-mhra-webcovid-202202240911559480-3ab5z. other case identifier(s): gb-mhra-adr 26645539. a 14 year-old male patient received bnt162b2 (comirnaty), administration date 15feb2022 (batch/lot number: unknown) as dose 2, single for covid-19 immunisation. the patient's relevant medical history and concomitant medications were not reported. patient did not have symptoms associated with covid-19. patient was not enrolled in clinical trial. vaccination history included: covid-19 vaccine (dose 1; manufacturer unknown), for covid-19 immunisation. the following information was reported: influenza like illness (medically significant) with onset 17feb2022, outcome "not recovered", described as "flu like symptoms". the patient underwent the following laboratory tests and procedures: sars-cov-2 test: (15feb2022) no - negative 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; information about lot/batch number cannot be obtained. no further information is expected

Lab Data
test date: 20220215; test name: covid-19 virus test; result unstructured data: test result:no - negative covid-19 test
List of symptoms
influenza like illness 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