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: fd7959
- Date report was received
- 2022-03-04
- Date form completed
- Date Vaccinated
- 2021-06-26
- Date of Onset
- 0
- Number of days (onset date – vaccination date)
- 0
- Adverse Event Description
-
bowel blood for 6 months; fatigue for 3 months.; sleepiness; headache after both doses; headache after both doses; inappropriate schedule of vaccine administered; this is a spontaneous report received from a contactable reporter(s) (consumer or other non hcp) from the regulatory authority-web. the reporter is the patient. regulatory number: it-minisal02-842230. a 43 year-old male patient received bnt162b2 (comirnaty), intramuscular, administration date 26jun2021 (lot number: fd7959) as dose 2, single for covid-19 immunisation. relevant medical history included: "vasculitis" (unspecified if ongoing); "vasculitis" (unspecified if ongoing); "hemochromatosis" (unspecified if ongoing). the patient's concomitant medications were not reported. vaccination history included: comirnaty (1st dose, batch/ lot number: fa5831), administration date: 15may2021, for covid-19 immunisation, reaction(s): "tiredness", "sleepiness", "bloody discharge", "pain", "angina pectoris". the following information was reported: bloody discharge (medically significant) with onset 30jun2021, outcome "not recovered", described as "bowel blood for 6 months"; fatigue (non-serious) with onset 30jun2021, outcome "not recovered", described as "fatigue for 3 months."; somnolence (non-serious) with onset 30jun2021, outcome "not recovered", described as "sleepiness"; pain (non-serious) with onset 30jun2021, outcome "not recovered", headache (non-serious) with onset 30jun2021, outcome "unknown" and all described as "headache after both doses"; inappropriate schedule of product administration (non-serious) with onset 26jun2021, outcome "unknown", described as "inappropriate schedule of vaccine administered". the clinical course of events was as follows: actions taken (the gut softer oily and i saw blood) - impact on quality of life (7/10). event as reported: bowel blood for 6 months - drowsiness. headache after both doses ... pfitzer vaccine. i had severe angina pectoris 1 week after the first dose. fatigue for 3 months. reporter comment: vasculitis and hemochromatosis follow-up attempts are completed. no further information is expected.; reporter's comments: vasculitis and hemochromatosis; sender's comments: linked report(s) : it-pfizer inc-202200324661 1st/ 2nd dose
- Lab Data
-
na
- List of symptoms
-
fatigue headache pain somnolence inappropriate schedule of product administration bloody discharge
- 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