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
- 2021-12-15
- Date of Onset
- 4
- Number of days (onset date – vaccination date)
- 4
- Adverse Event Description
-
precordial pain; myocarditis; troponin up to 4500; this is a spontaneous report received from a contactable reporter(s) (physician) from the ra-web. regulatory number: gr-greof-202200509. a 23 year-old male patient received bnt162b2 (comirnaty), administration date 15dec2021 (lot number: unknown) as dose 2, single for covid-19 immunisation. the patient's relevant medical history and concomitant medications were not reported. vaccination history included: covid-19 vaccine (dose 1, manufacturer unknown), for covid-19 immunisation. the following information was reported: myocarditis (life threatening) with onset 19dec2021, outcome "recovering", described as "myocarditis"; troponin increased (life threatening) with onset 19dec2021, outcome "recovering", described as "troponin up to 4500"; chest pain (medically significant), outcome "unknown", described as "precordial pain". the patient underwent the following laboratory tests and procedures: troponin: (19dec2021) 4500, notes: 4500; (unspecified date) 62.4, notes: on discharge. no follow-up attempts are possible; information about lot/batch number cannot be obtained. no further information is expected
- Lab Data
-
test date: 20211219; test name: troponin; result unstructured data: test result:4500; comments: 4500; test name: troponin; result unstructured data: test result:62.4; comments: on discharge
- List of symptoms
-
chest pain myocarditis troponin increased troponin
- 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