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VAERS Report 2157080

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: unknown


Date report was received
2022-03-04
Date form completed
Date Vaccinated
2021-12-03
Date of Onset
30
Number of days (onset date – vaccination date)
30
Adverse Event Description

sars-cov-2 test positive 30 days after the third dose of the vaccine; sars-cov-2 test positive 30 days after the third dose of the vaccine; this is a spontaneous report received from a contactable reporter(s) (physician) from the ra-web. regulatory number: gr-greof-202200824. a 57-year-old female patient received bnt162b2 (comirnaty), administration date 03dec2021 (batch/lot number: unknown) as dose 3 (booster), single, administration date 21may2021 (batch/lot number: unknown) as dose 2, single and administration date 16apr2021 (batch/lot number: unknown) as dose 1, single for covid-19 immunisation. relevant medical history included: "breast cancer" (unspecified if ongoing) and normal ca 15-3. the patient's concomitant medications were not reported. past drug history included: letrozole for breast cancer. the following information was reported: vaccination failure (medically significant), covid-19 (medically significant) all with onset 02jan2022, outcome "unknown" and all described as "sars-cov-2 test positive 30 days after the third dose of the vaccine". the patient underwent the following laboratory tests and procedures: sars-cov-2 test: (02jan2022) positive, notes: 3o days after the third dose of the vaccine. it was reported that after 30 days of 3rd dose, the patient got infected from covid-19. no follow-up attempts are possible; information about lot/batch number cannot be obtained. no further information is expected.; sender's comments: linked report(s) : gr-pfizer inc-202200336837 same reporter, same patient, different dose of the vaccine, different event

Lab Data
test date: 20220102; test name: sars-cov-2 test; test result: positive ; comments: 3o days after the third dose of the vaccine
List of symptoms
covid-19 sars-cov-2 test vaccination failure
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