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: f06840
- Date report was received
- 2022-03-04
- Date form completed
- Date Vaccinated
- 2021-07-03
- Date of Onset
- 122
- Number of days (onset date – vaccination date)
- 122
- Adverse Event Description
-
i got covid-19. 02nov2021. i had mild symptoms.; i got covid-19. 02nov2021. i had mild symptoms.; this is a spontaneous report received from a contactable reporter(s) (consumer or other non hcp) from the regulatory authority-web and health authority. the reporter is the patient. a 46 year-old female patient received bnt162b2 (comirnaty), intramuscular, administration date 03jul2021 (lot number: f06840) as dose 2, 0.3 ml single and intramuscular, administration date 29may2021 (lot number: fc8736) as dose 1, 0.3 ml single for covid-19 immunisation. relevant medical history included: "intra-uterine contraceptive device insertion" (not ongoing), notes: she had a insertion mirena spiral. concomitant medication(s) included: mirena taken for intrauterine contraception. the following information was reported: drug ineffective (medically significant), outcome "unknown", suspected covid-19 (medically significant) with onset 02nov2021, outcome "unknown" and all described as "i got covid-19. 02nov2021. i had mild symptoms.". therapeutic measures were taken as a result of drug ineffective, suspected covid-19. no follow-up attempts are needed. no further information is expected
- Lab Data
-
na
- List of symptoms
-
drug ineffective suspected covid-19
- 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