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VAERS Report 2156982

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: unknown


Date report was received
2022-03-04
Date form completed
Date Vaccinated
2021-12-18
Date of Onset
7
Number of days (onset date – vaccination date)
7
Adverse Event Description

sars-cov-2 infection; sars-cov-2 infection; this is a spontaneous report received from a contactable reporter(s) (consumer or other non hcp) from the regulatory agency. a 53 year-old female patient (not pregnant) received bnt162b2 (comirnaty), administration date 18dec2021 (batch/lot number: unknown) as dose 3(booster), single for covid-19 immunisation; covid-19 vaccine nrvv ad (chadox1 ncov-19) (covid-19 vaccine astrazeneca), administration date 12jun2021 (batch/lot number: unknown) as dose 2, single and administration date 13mar2021 (batch/lot number: unknown) as dose 1, single for covid-19 immunisation. relevant medical history included: "blood urine" (unspecified if ongoing). date of last menstrual period: 03jul2020. concomitant medication(s) included: nitrofurantoin taken for blood urine, start date: 27jul2021, stop date: 01aug2021. the following information was reported: drug ineffective (medically significant) with onset 25dec2021, outcome "unknown", covid-19 (medically significant) with onset 25dec2021, outcome "recovered" (04jan2022) and all described as "sars-cov-2 infection". date of lmp was 03jul2020. it was unsure if patient had symptoms associated with covid-19, she did not have a covid-19 test. the patient is not pregnant and not currently breastfeeding. the patient had swelling in arm pit on same side as vaccination and in lymph nodes on collarbone but opposite side to the vaccination. the swelling in armpit resolved after about 3 days. the lymph node on collarbone is improved but still slightly swollen, but no longer as painful. no follow-up attempts are possible; information about lot/batch number cannot be obtained. no further information is expected

Lab Data
na
List of symptoms
drug ineffective covid-19
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