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VAERS Report 2157299

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: fn4071


Date de réception du rapport
2022-03-04
Date à laquelle le formulaire est complèté
Date de vaccination
2022-02-04
Date d’apparition
3
Nombre de jours (date d’apparition – date de vaccination)
3
Description de l’événement indésirable

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

Données de laboratoire
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
Liste des symptômes
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 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