Détails du rapport Vaer
Âge: N/A
Genre: Male
Région : Outside US
- Patient décédé?
- Non
- Renseignements sur les vaccins
-
Nom: COVID19 (COVID19 (PFIZER-BIONTECH))
Type : Coronavirus 2019 vaccine
Fabricant: PFIZER
Lot: fk9707
- Date de réception du rapport
- 2022-03-04
- Date à laquelle le formulaire est complèté
- Date de vaccination
- 2021-12-15
- Date d’apparition
- 73
- Nombre de jours (date d’apparition – date de vaccination)
- 73
- Description de l’événement indésirable
-
covid-19 positive test by lft; covid-19 positive test by lft; this is a spontaneous report received from contactable consumer from product quality and a sales representative. the reporter is the patient. a male patient received bnt162b2 (comirnaty, solution for injection), intramuscular, administered in arm left, administration date 15dec2021 12:00 (lot number: fk9707) as dose 3 (booster), single; intramuscular, administered in arm left, administration date 24may2021 12:00 (lot number: et1831) as dose 2, single; and intramuscular, administered in arm left, administration date 04may2021 12:00 (lot number: et3620) as dose 1, single for covid-19 immunisation. the patient's relevant medical history was not reported. there were no concomitant medications (no other vaccines within 4 weeks prior to the covid vaccine and other medications received within 2 weeks of vaccination). the following information was reported: vaccination failure (medically significant) with onset 26feb2022 08:00, outcome "unknown", covid-19 (medically significant) with onset 26feb2022 08:00, outcome "not recovered" and all described as "covid-19 positive test by lft". the patient underwent the following laboratory tests and procedures: sars-cov-2 test: (26feb2022) positive, notes: nasal swab. therapeutic measures were not taken as a result of covid-19. no follow-up attempts are possible. no further information is expected.; sender's comments: linked report(s) : gb-pfizer inc-2021611909 same patient/suspect drug, different dose number/event;gb-pfizer inc-202101819200 same patient/suspect drug, different dose number/event
- Données de laboratoire
-
test date: 20220226; test name: lft; test result: positive ; comments: nasal swab
- Liste des symptômes
-
covid-19 sars-cov-2 test vaccination failure
- 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