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VAERS Report 2157019

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: fe1510


Date report was received
2022-03-04
Date form completed
Date Vaccinated
2021-07-21
Date of Onset
168
Number of days (onset date – vaccination date)
168
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 ra and product quality group. the reporter is the patient. a 34 year-old female patient received bnt162b2 (bnt162b2), administration date 02jun2021 (lot number: ew3143) as dose 1, single and administration date 21jul2021 (lot number: fe1510) as dose 2, single for covid-19 immunisation. the patient's relevant medical history and concomitant medications were not reported. the following information was reported: drug ineffective (medically significant) with onset 05jan2022, outcome "recovered" (17jan2022), described as "drug ineffective"; suspected covid-19 (medically significant) with onset 05jan2022, outcome "recovered" (17jan2022), described as "covid-19". additional information: patient last menstrual period date was reported as 21jan2022. no follow-up attempts are possible. no further information is expected.; sender's comments: linked report(s) : gb-pfizer inc-202200333912 same patient/drug and different dose/events (dose 2);gb-pfizer inc-202200323270 same patient/drug and different dose/events (dose 1)

Lab Data
na
List of symptoms
drug ineffective suspected 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