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VAERS Report 2157320

Case Report Section

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