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VAERS Report 2157001

Case Report Section

Détails du rapport Vaer

Âge: N/A

Genre: Female

Région : Outside US

Patient décédé?
Non
Renseignements sur les vaccins

Nom: COVID19 (COVID19 (PFIZER-BIONTECH))

Type : Coronavirus 2019 vaccine

Fabricant: PFIZER

Lot: unknown


Date de réception du rapport
2022-03-04
Date à laquelle le formulaire est complèté
Date de vaccination
2021-11-01
Date d’apparition
63
Nombre de jours (date d’apparition – date de vaccination)
63
Description de l’événement indésirable

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 ra. a female patient received bnt162b2 (comirnaty), administration date nov2021 (batch/lot number: unknown) as dose 3 (booster), single, administration date apr2021 (batch/lot number: unknown) as dose 2, single and administration date jan2021 (batch/lot number: unknown) as dose 1, single for covid-19 immunisation. the patient's relevant medical history and concomitant medications were not reported. it was reported that patient has not had symptoms associated with covid-19. the following information was reported: drug ineffective (medically significant) with onset 03jan2022, outcome "unknown", suspected covid-19 (medically significant) with onset 03jan2022, outcome "recovered" (05jan2022) and all described as "sars-cov-2 infection". the patient underwent the following laboratory tests and procedures: sars-cov-2 test: negative, notes: no - negative covid-19 test. patient was not enrolled in clinical trial. the report does not relate 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.; sender's comments: linked report(s) : gb-pfizer inc-202200298677 same patient/product/ reporter, different dose number/ event

Données de laboratoire
test name: covid-19 virus test; test result: negative ; comments: no - negative covid-19 test
Liste des symptômes
drug ineffective sars-cov-2 test suspected covid-19
Patient décédé?
Non
Date de décès
N/A
Anomalie congénitale
false
Vaccin administré par :
Other
Vaccin acheté par :
Inconnu
Visite d’un patient à l’urgence?
Non
Patient hospitalisé?
Non
Séjour à l’hôpital
Non
Nombre de jours à l’hôpital
Non spécifié
Invalidité permanente?
Non
Allergies:
na
Maladie actuelle
na