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VAERS Report 2157013

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
Date of Onset
0
Number of days (onset date – vaccination date)
0
Adverse Event Description

drug ineffective; covid-19; this is a spontaneous report received from a contactable reporter(s) (consumer or other non hcp) from the regulatory authority (ra) and health authority. a 69 year-old male patient received bnt162b2 (bnt162b2) (batch/lot number: unknown) as dose 1, single and (batch/lot number: unknown) as dose 2, single for covid-19 immunisation. relevant medical history included: "suspected covid-19", start date: 09dec2021, stop date: 15dec2021. the patient's concomitant medications were not reported. the following information was reported: drug ineffective (medically significant) with onset 14feb2022, outcome "unknown", described as "drug ineffective"; covid-19 (medically significant) with onset 14feb2022, outcome "unknown", described as "covid-19". the patient underwent the following laboratory tests and procedures: sars-cov-2 test: (14feb2022) yes - positive covid-19 test. 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-202200307638 same patient/product, different dose/events

Lab Data
test date: 20220214; test name: covid-19 virus test; result unstructured data: test result: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