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VAERS Report 2157329

Case Report Section

Détails du rapport Vaer

Âge: 46 ans

Genre: Male

Région : Outside US

Patient décédé?
Non
Renseignements sur les vaccins

Nom: COVID19 (COVID19 (PFIZER-BIONTECH))

Type : Coronavirus 2019 vaccine

Fabricant: PFIZER

Lot: ep2166


Date de réception du rapport
2022-03-04
Date à laquelle le formulaire est complèté
Date de vaccination
2021-03-09
Date d’apparition
0
Nombre de jours (date d’apparition – date de vaccination)
0
Description de l’événement indésirable

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

Données de laboratoire
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
Liste des symptômes
headache chest pain hypoaesthesia skin irritation visual impairment ultrasound scan magnetic resonance imaging head
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?
Non
Séjour à l’hôpital
Non
Nombre de jours à l’hôpital
Non spécifié
Invalidité permanente?
Oui
Allergies:
na
Maladie actuelle
na