Vaer Report Details
Age: 43 years old
Gender: Female
State: Outside US
- Patient Died?
- No
- Vaccine information
-
Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Type: Coronavirus 2019 vaccine
Manufacturer: PFIZER
Lot: unknown
- Date report was received
- 2022-03-04
- Date form completed
- Date Vaccinated
- 2021-12-22
- Date of Onset
- 0
- Number of days (onset date – vaccination date)
- 0
- Adverse Event Description
-
hyperpyrexia; flushing; bullae; ache; tachycardia; this is a spontaneous report received from a contactable reporter(s) (consumer or other non hcp) from the ra-web. regulatory number: it-minisal02-843284. a 43 year-old female patient received bnt162b2 (comirnaty), intramuscular, administration date 22dec2021 (batch/lot number: unknown) at the age of 43 years as dose number unknown, single for covid-19 immunisation. the patient's relevant medical history and concomitant medications were not reported. the following information was reported: hyperpyrexia (medically significant) with onset 22dec2021, outcome "not recovered", described as "hyperpyrexia"; flushing (non-serious) with onset 22dec2021, outcome "not recovered", described as "flushing"; blister (non-serious) with onset 22dec2021, outcome "not recovered", described as "bullae"; pain (non-serious) with onset 22dec2021, outcome "not recovered", described as "ache"; tachycardia (non-serious) with onset 22dec2021, outcome "not recovered", described as "tachycardia". sender's comments: the reporter has already been asked for more information, explanation. no follow-up attempts are possible; information about lot/batch number cannot be obtained. no further information is expected
- Lab Data
-
na
- List of symptoms
-
pain flushing blister tachycardia hyperpyrexia
- 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?
- No
- Allergies:
-
na
- Current Illness
-
na