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VAERS Report 2157298

Case Report Section

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: fg6270


Date report was received
2022-03-04
Date form completed
Date Vaccinated
2021-10-12
Date of Onset
116
Number of days (onset date – vaccination date)
116
Adverse Event Description

postural instability due to probable cerebral ischemia; probable cerebral ischemia; this is a spontaneous report received from a contactable reporter(s) (physician) from the regulatory authority-web. regulatory number: it-minisal02-842621. a 85 year-old male patient received bnt162b2 (comirnaty), intramuscular, administered in arm left, administration date 12oct2021 15:00 (lot number: fg6270, expiration date: 31mar2022) as dose 3 (booster), 0.3 ml single for covid-19 immunisation. the patient's relevant medical history and concomitant medications were not reported. vaccination history included: covid-19 vaccine (first dose, unknown manufacturer), for covid-19 immunisation; covid-19 vaccine (second dose, unknown manufacturer), for covid-19 immunisation. the following information was reported: balance disorder (hospitalization) with onset 05feb2022, outcome "unknown", described as "postural instability due to probable cerebral ischemia"; cerebral ischaemia (hospitalization) with onset 05feb2022, outcome "unknown", described as "probable cerebral ischemia". no follow-up attempts are possible. no further information is expected

Lab Data
na
List of symptoms
balance disorder cerebral ischaemia
Patient Died?
No
Date Died
NA
Birth defect
false
Vaccine Administered By:
Other
Vaccine Purchased By:
Unknown
Patient visit ER?
No
Patient Hospitalized?
Yes
Stay in hospital
No
Days in hospital
Unspecified
Permanent disability?
No
Allergies:
na
Current Illness
na