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VAERS Report 2157298

Case Report Section

Détails du rapport Vaer

Âge: N/A

Genre: Male

Région : Outside US

Patient décédé?
Non
Renseignements sur les vaccins

Nom: COVID19 (COVID19 (PFIZER-BIONTECH))

Type : Coronavirus 2019 vaccine

Fabricant: PFIZER

Lot: fg6270


Date de réception du rapport
2022-03-04
Date à laquelle le formulaire est complèté
Date de vaccination
2021-10-12
Date d’apparition
116
Nombre de jours (date d’apparition – date de vaccination)
116
Description de l’événement indésirable

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

Données de laboratoire
na
Liste des symptômes
balance disorder cerebral ischaemia
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
na