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: unknown
- Date report was received
- 2022-03-04
- Date form completed
- Date Vaccinated
- 2022-01-13
- Date of Onset
- 19
- Number of days (onset date – vaccination date)
- 19
- Adverse Event Description
-
impact on quality of life (8/10).; unintended movements of the right arm, similar to parkinson's; worsening of depression; this is a spontaneous report received from a contactable reporter(s) (consumer or other non hcp) from the regulatory authority web. regulatory number: it-minisal02-842815 a 67 year-old male patient received bnt162b2 (comirnaty), intramuscular, administered in arm right, administration date 13jan2022 (batch/lot number: unknown) as dose 3 (booster), single for covid-19 immunisation. relevant medical history included: "depression" (unspecified if ongoing); "heart problems" (unspecified if ongoing), notes: heart problems. the patient's concomitant medications were not reported. vaccination history included: covid-19 vaccine (dose 1, manufacturer unknown), for covid-19 immunization; covid-19 vaccine (dose 2, manufacturer unknown), for covid-19 immunisation. the following information was reported: dyskinesia (disability) with onset 01feb2022, outcome "not recovered", described as "unintended movements of the right arm, similar to parkinson's"; depression (disability) with onset 01feb2022, outcome "not recovered", described as "worsening of depression"; quality of life decreased (non-serious), outcome "unknown", described as "impact on quality of life (8/10).". reporter comment: depression, heart problems senders comment: mail for information 09feb22 and reminder 14feb22 no follow-up attempts are possible; information about lot/batch number cannot be obtained. no further information is expected.; reporter's comments: depression, heart problems
- Lab Data
-
na
- List of symptoms
-
depression dyskinesia quality of life decreased
- 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?
- Yes
- Allergies:
-
na
- Current Illness
-
na