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VAERS Report 2156894

Case Report Section

Vaer Report Details

Age: 14 years old

Gender: Male

State: Outside US

Patient Died?
No
Vaccine information

Name: COVID19 (COVID19 (PFIZER-BIONTECH))

Type: Coronavirus 2019 vaccine

Manufacturer: PFIZER

Lot: fl99911


Date report was received
2022-03-04
Date form completed
Date Vaccinated
2022-02-17
Date of Onset
0
Number of days (onset date – vaccination date)
0
Adverse Event Description

diarrhea; this is a spontaneous report received from a contactable reporter (consumer) from the regulatory authority (ra). regulatory number: gb-mhra-webcovid-202202241010557130-ngezr. other case identifier(s): gb-mhra-adr 26648973. a 14 year-old male patient received bnt162b2 (comirnaty), administration date 17feb2022 (lot number: fl99911) at the age of 14 years as dose number unknown, single for covid-19 immunisation. the patient's relevant medical history and concomitant medications were not reported. it was unsure if patient has had symptoms associated with covid-19. patient was not enrolled in clinical trial. the following information was reported: diarrhoea (medically significant) with onset 17feb2022, outcome "not recovered", described as "diarrhea". the patient underwent the following laboratory tests and procedures: sars-cov-2 test: (23feb2022) 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. no further information is expected

Lab Data
test date: 20220223; test name: covid-19 virus test; result unstructured data: test result:no - negative covid-19 test
List of symptoms
diarrhoea 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