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: fn4071
- Date report was received
- 2022-03-04
- Date form completed
- Date Vaccinated
- 2022-02-04
- Date of Onset
- 3
- Number of days (onset date – vaccination date)
- 3
- Adverse Event Description
-
rash pruritic/itchy rash occurred on the face/subsequent itchy rash at face; difficulty in walking/uncertain walking; speech disorder/; consciousness loss of/loss of consciousness; slowing speech / successively speech slows down; this is a spontaneous report received from a contactable reporter(s) (physician) from the regulatory authority-web. regulatory number: it-minisal02-842646. a 9 year-old male patient received bnt162b2 (comirnaty), intramuscular, administered in arm left, administration date 04feb2022 15:26 (lot number: fn4071) as dose 2, single for covid-19 immunisation. the patient's relevant medical history and concomitant medications were not reported. vaccination history included: comirnaty (dose 1, single, manufacturer unknown , 16:07 - fn4071 - left deltoid), administration date: 06jan2022, for covid-19 immunization. the following information was reported: gait disturbance (hospitalization) with onset 07feb2022, outcome "recovered" (08feb2022), described as "difficulty in walking/uncertain walking"; speech disorder (hospitalization) with onset 07feb2022, outcome "recovered" (08feb2022), described as "speech disorder/"; loss of consciousness (hospitalization, medically significant) with onset 07feb2022, outcome "recovered" (08feb2022), described as "consciousness loss of/loss of consciousness"; rash pruritic (hospitalization) with onset 09feb2022, outcome "unknown", described as "rash pruritic/itchy rash occurred on the face/subsequent itchy rash at face"; slow speech (non-serious) with onset 2022, outcome "unknown", described as "slowing speech / successively speech slows down". the patient was hospitalized for rash pruritic (discharge date: 11feb2022). the patient underwent the following laboratory tests and procedures: blood test: (feb2022) unknown; computerised tomogram head: (feb2022) unknown; electrocardiogram: (feb2022) unknown; electroencephalogram: (feb2022) unknown; investigation: (feb2022) unknown; lumbar puncture: (feb2022) unknown; magnetic resonance imaging head: (feb2022) unknown. additional information: on 15feb2022, at the request of the privacy, the reporter was asked for a clinical report or hospital discharge letter or any other information which was useful for the case assessment. on 17jan2022 we receive and attach: report on hospitalization and instrumental examinations carried out. no follow-up attempts are possible. no further information is expected
- Lab Data
-
test date: 202202; test name: blood tests; result unstructured data: test result:unknown; test date: 202202; test name: computed tomography of the brain; result unstructured data: test result:unknown; test date: 202202; test name: electrocardiogram; result unstructured data: test result:unknown; test date: 202202; test name: electroencephalogram; result unstructured data: test result:unknown; test date: 202202; test name: instrumental examinations; result unstructured data: test result:unknown; test date: 202202; test name: spinal tap; result unstructured data: test result:unknown; test date: 202202; test name: brain magnetic resonance imaging; result unstructured data: test result:unknown
- List of symptoms
-
investigation gait disturbance rash pruritic speech disorder loss of consciousness lumbar puncture electrocardiogram blood test electroencephalogram computerised tomogram head magnetic resonance imaging head slow speech
- 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