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VAERS Report 2157014

Case Report Section

Vaer Report Details

Age: NA

Gender: Unknown

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
2021-01-18
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. the reporter is the patient. a 29 year-old patient received bnt162b2 (bnt162b2), administration date 18jan2021 (batch/lot number: unknown) as dose 2, single for covid-19 immunisation; covid-19 vaccine (covid-19 vaccine) (batch/lot number: unknown) as dose 1, single for covid-19 immunisation. the patient's relevant medical history and concomitant medications were not reported. patient has not had symptoms associated with covid-19.patient is not enrolled in clinical trial adverse reaction did not occur as a result of an exposure during pregnancy. the following information was reported: drug ineffective (medically significant), outcome "unknown", described as "drug ineffective"; covid-19 (medically significant), outcome "unknown", described as "covid-19". the patient underwent the following laboratory tests and procedures: sars-cov-2 test: (04jan2022) positive, notes: 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-202200299079 same patient/vaccine product, different events

Lab Data
test date: 20220104; test name: covid-19 virus test; test result: positive ; comments: 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