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VAERS Report 2157331

Case Report Section

Détails du rapport Vaer

Âge: N/A

Genre: Male

Région : Outside US

Patient décédé?
Non
Renseignements sur les vaccins

Nom: COVID19 (COVID19 (PFIZER-BIONTECH))

Type : Coronavirus 2019 vaccine

Fabricant: PFIZER

Lot: fn4071


Date de réception du rapport
2022-03-04
Date à laquelle le formulaire est complèté
Date de vaccination
2022-02-04
Date d’apparition
1
Nombre de jours (date d’apparition – date de vaccination)
1
Description de l’événement indésirable

blackout spell; tremor; fall; vagal reaction; this is a spontaneous report received from a contactable reporter(s) (physician) from the agency regulatory authority-web. regulatory number: it-minisal02-842962. a 7 year-old male patient received bnt162b2 (comirnaty), intramuscular, administration date 04feb2022 (lot number: fn4071) as dose 1, 0.2 ml single for covid-19 immunisation. the patient's relevant medical history and concomitant medications were not reported. the following information was reported: loss of consciousness (medically significant) with onset 05feb2022, outcome "recovered" (05feb2022), described as "blackout spell"; tremor (non-serious) with onset 05feb2022, outcome "recovered" (05feb2022), described as "tremor"; fall (non-serious) with onset 05feb2022, outcome "recovered" (05feb2022), described as "fall"; presyncope (non-serious) with onset 05feb2022, outcome "recovered" (05feb2022), described as "vagal reaction". therapeutic measures were taken as a result of loss of consciousness, tremor, fall, presyncope. additional information: the events lasted a few seconds. prompt recovery after administration of glucose and water. no follow-up attempts are possible. no further information is expected

Données de laboratoire
na
Liste des symptômes
tremor loss of consciousness fall presyncope
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?
Non
Allergies:
na
Maladie actuelle
na