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
- 2021-04-03
- Date of Onset
- 89
- Number of days (onset date – vaccination date)
- 89
- Adverse Event Description
-
esophagitis; anemia; headache; this is a spontaneous report received from a contactable reporter (physician) from the regulatory authority-web. regulatory number: gr-greof-20217675 (ra). a 77 year-old male patient received bnt162b2 (comirnaty), intramuscular, administration date 03apr2021 (batch/lot number: unknown) as dose 2, single for covid-19 immunisation. the patient's relevant medical history was not reported. concomitant medication(s) included: omnic tocas; coaprovel. vaccination history included: comirnaty (dose 1, batch/lot number :unknown, route of administration: intramuscular), administration date: 13mar2021, for covid-19 immunisation. the following information was reported: oesophagitis (hospitalization, medically significant) with onset 01jul2021, outcome "recovering", described as "esophagitis"; anaemia (hospitalization, medically significant) with onset 01jul2021, outcome "not recovered", described as "anemia"; headache (disability) with onset 01jul2021, outcome "not recovered", described as "headache". the patient underwent the following laboratory tests and procedures: inflammatory marker test: inflammatory markers for an extended period of, notes: time. therapeutic measures were taken as a result of anaemia, headache. clinical details: the patient presented with esophagitis grade 2 with anemia and inflammatory markers for an extended period of time without any other foci of inflammation. headache was localized and did not subside with the usual painkillers. no follow-up attempts are possible; information about lot/batch number cannot be obtained. no further information is expected
- Lab Data
-
test name: inflammatory marker; result unstructured data: test result:inflammatory markers for an extended period of; comments: time
- List of symptoms
-
headache anaemia oesophagitis inflammatory marker test
- Patient Died?
- No
- Date Died
- NA
- Birth defect
- false
- Vaccine Administered By:
- Other
- Vaccine Purchased By:
- Unknown
- Patient visit ER?
- No
- Patient Hospitalized?
- Yes
- Stay in hospital
- No
- Days in hospital
- Unspecified
- Permanent disability?
- Yes
- Allergies:
-
na
- Current Illness
-
na