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VAERS Report 2157118

Case Report Section

Détails du rapport Vaer

Âge: N/A

Genre: Female

Région : Outside US

Patient décédé?
Non
Renseignements sur les vaccins

Nom: COVID19 (COVID19 (PFIZER-BIONTECH))

Type : Coronavirus 2019 vaccine

Fabricant: PFIZER

Lot: fe2296


Date de réception du rapport
2022-03-04
Date à laquelle le formulaire est complèté
Date de vaccination
2021-07-21
Date d’apparition
166
Nombre de jours (date d’apparition – date de vaccination)
166
Description de l’événement indésirable

peripheral embolism; this is a spontaneous report received from a contactable reporter(s) (physician) from the regulatory authority web. regulatory number: hu-ogyi-0027222. a 63 year-old female patient received bnt162b2 (comirnaty), intramuscular, administered in arm left, administration date 21jul2021 (lot number: fe2296) as dose 2, 0.3 ml single for covid-19 immunisation. relevant medical history included: "hypertension" (ongoing). concomitant medication(s) included: lisonorm taken for hypertension, start date: 03mar2015; rawel taken for hypertension, start date: 01aug2018. vaccination history included: comirnaty (for dose 1, comirnaty, route of administration: intramuscular, anatomical location: left arm, date of administration: 01jul2021 , lot/batch number: fd0168), administration date: 01jul2021, when the patient was 63 years old, for covid-19 immunization. the following information was reported: peripheral embolism (hospitalization) with onset 03jan2022, outcome "recovering", described as "peripheral embolism". sender's comirnaty, peripheral embolism is not listed and not expected. tto is circa 5 months. dechallenge and rechallenge were not applicable. the causal relationship between the suspected drug and the event is considered unlikely. the case is considered serious due to reported hospitalization. no follow-up attempts are possible. no further information is expected

Données de laboratoire
na
Liste des symptômes
peripheral embolism
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?
Oui
Séjour à l’hôpital
Non
Nombre de jours à l’hôpital
Non spécifié
Invalidité permanente?
Non
Allergies:
na
Maladie actuelle
hypertension