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: fg3739
- Date report was received
- 2022-03-04
- Date form completed
- Date Vaccinated
- 2021-10-14
- Date of Onset
- 0
- Number of days (onset date – vaccination date)
- 0
- Adverse Event Description
-
dehydration; diarrhea; abdominal pain; vomiting aggravated/ incoercible vomiting; this is a spontaneous report received from a contactable reporter(s) (consumer or other non hcp) from the regulatory authority-web. regulatory number: it-minisal02-842874. a 44 year-old male patient received bnt162b2 (comirnaty, solution for injection), intramuscular, administered in deltoid left, administration date 14oct2021 10:53 (lot number: fg3739) as dose number unknown, single for covid-19 immunisation. relevant medical history included: "allergy to various food" (unspecified if ongoing); "arterial hypertension" (unspecified if ongoing), notes: in pharmacological treatment.; "dyslipidemia" (unspecified if ongoing). the patient's concomitant medications were not reported. the following information was reported: vomiting (hospitalization) with onset 14oct2021, outcome "recovered with sequelae", described as "vomiting aggravated/ incoercible vomiting"; dehydration (hospitalization) with onset 18oct2021, outcome "recovered with sequelae", described as "dehydration"; diarrhoea (hospitalization) with onset 14oct2021, outcome "recovered with sequelae", described as "diarrhea"; abdominal pain (hospitalization) with onset 14oct2021, outcome "recovered with sequelae", described as "abdominal pain". therapeutic measures were taken as a result of vomiting, dehydration, diarrhoea, abdominal pain. clinical information: actions taken (liquid-based treatments, re-integration of serum electrolytes, antiemetics and anti-acids-). impact on the quality of life (8/10). no follow-up attempts are possible. no further information is expected
- Lab Data
-
na
- List of symptoms
-
diarrhoea vomiting abdominal pain dehydration
- 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