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VAERS Report 2157007

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
Date of Onset
0
Number of days (onset date – vaccination date)
0
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 ra. the reporter is the patient. a 62 year-old female patient received bnt162b2 (bnt162b2), administration date 10mar2021 (batch/lot number: unknown) as dose number unknown , single and (batch/lot number: unknown) as dose 1, single for covid-19 immunisation. relevant medical history included: "constipation" (unspecified if ongoing). the patient's concomitant medications were not reported. patient has not had symptoms associated with covid-19. the following information was reported: drug ineffective (medically significant), covid-19 (medically significant) all with onset 09jul2021, outcome "not recovered" and all described as "sars-cov-2 infection". a stop date of 18feb2022 was reported for sars-cov-2 infection. the patient underwent the following laboratory tests and procedures: sars-cov-2 test: (09jul2021) positive, notes: yes - positive covid-19 test. no follow-up attempts are possible; information about lot/batch number cannot be obtained. no further information is expected

Lab Data
test date: 20210709; test name: covid-19 virus test; test result: positive ; comments: yes - positive covid-19 test
List of symptoms
drug ineffective covid-19 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