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VAERS Report 2157035

Case Report Section

Détails du rapport Vaer

Âge: 36 ans

Genre: Female

Région : Outside US

Patient décédé?
Non
Renseignements sur les vaccins

Nom: COVID19 (COVID19 (PFIZER-BIONTECH))

Type : Coronavirus 2019 vaccine

Fabricant: PFIZER

Lot: unknown


Date de réception du rapport
2022-03-04
Date à laquelle le formulaire est complèté
Date de vaccination
2021-07-15
Date d’apparition
0
Nombre de jours (date d’apparition – date de vaccination)
0
Description de l’événement indésirable

intense headache,frequent the first 15 days,decreased the next 15 days; vitiligo relapse 7 days since the first dose,other factors excluded; this is a spontaneous report received from a contactable reporter (consumer) from the regulatory authority-web. regulatory number: gr-greof-202108956 (ra). a 36-year-old female patient received bnt162b2 (comirnaty), administration date 15jul2021 (lot number: unknown) at the age of 36 years as dose 1, single for covid-19 immunisation. relevant medical history included: "thyroid gland (has autoimmune disease)" (unspecified if ongoing); "patient was a lactating woman" (unspecified if ongoing). the patient's concomitant medications were not reported. the following information was reported: headache (medically significant) with onset 15jul2021, outcome "recovered", described as "intense headache, frequent the first 15 days, decreased the next 15 days"; vitiligo (medically significant) with onset 15jul2021, outcome "unknown", described as "vitiligo relapse 7 days since the first dose, other factors excluded". clinical course: the patient was a lactating woman. no allergy. non-smoker, no drug abuse. the thyroid gland (has autoimmune disease) was not affected. no follow-up attempts are possible; information about lot/batch number cannot be obtained. no further information is expected

Données de laboratoire
na
Liste des symptômes
headache vitiligo
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