Page breadcrumb nav

VAERS Report 2157329

Case Report Section

Vaer Report Details

Age: 46 years old

Gender: Male

State: Outside US

Patient Died?
No
Vaccine information

Name: COVID19 (COVID19 (PFIZER-BIONTECH))

Type: Coronavirus 2019 vaccine

Manufacturer: PFIZER

Lot: ep2166


Date report was received
2022-03-04
Date form completed
Date Vaccinated
2021-03-09
Date of Onset
0
Number of days (onset date – vaccination date)
0
Adverse Event Description

headache; decreased vision; numbness on the left side of the body; internal burning in the left thoracic area; skin irritation; this is a spontaneous report received from a contactable reporter(s) (consumer or other non hcp) from the regulatory authority web. regulatory number: it-minisal02-842937. a 46 year-old male patient received bnt162b2 (comirnaty), intramuscular, administration date 09mar2021 (lot number: ep2166) at the age of 46 years as dose 2, 0.3 ml, single for covid-19 immunisation. relevant medical history included: "allergies related to seasonal changes" (unspecified if ongoing); "hepatitis b" (unspecified if ongoing). the patient's concomitant medications were not reported. vaccination history included: comirnaty (dose 1, single, batch/lot number: ej6790), administration date: 16feb2021, for covid-19 immunization. the following information was reported: headache (disability) with onset 09mar2021, outcome "not recovered", described as "headache"; visual impairment (disability) with onset 09mar2021, outcome "not recovered", described as "decreased vision"; hypoaesthesia (disability) with onset 09mar2021, outcome "not recovered", described as "numbness on the left side of the body"; chest pain (disability) with onset 09mar2021, outcome "not recovered", described as "internal burning in the left thoracic area"; skin irritation (disability) with onset 09mar2021, outcome "not recovered", described as "skin irritation". the patient underwent the following laboratory tests and procedures: magnetic resonance imaging head: not reported; ultrasound scan: not reported. clinical course: patient received the third dose of bnt162b2 (comirnaty) into the right shoulder on 16dec2021 administration date 09mar2021 (lot number: fk6304 ) as dose 3, booster, single for covid-19 immunization. reporter comment: allergies related to seasonal changes. hepatitis b. no follow-up attempts are possible. no further information is expected.; reporter's comments: allergies related to seasonal changes. hepatitis b

Lab Data
test name: magnetic resonance imaging with contrast of the head; result unstructured data: test result:not reported; test name: ultrasound of the supra-aortic trunks; result unstructured data: test result:not reported
List of symptoms
headache chest pain hypoaesthesia skin irritation visual impairment ultrasound scan magnetic resonance imaging head
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