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: unknown
- Date report was received
- 2022-03-04
- Date form completed
- Date Vaccinated
- 2022-01-28
- Date of Onset
- 8
- Number of days (onset date – vaccination date)
- 8
- Adverse Event Description
-
guillain-barre syndrome; this is a spontaneous report received from a contactable reporter (physician) from the regulatory authority-web. regulatory number: it-minisal02-844182. a 41 year-old male patient received bnt162b2 (comirnaty), administration date 28jan2022 (lot number: unknown) as dose 3 (booster), single for covid-19 immunisation. relevant medical history included: "immunodeficiency" (unknown if ongoing); "hiv" (unspecified if ongoing). concomitant medication included: dovato. vaccination history included: covid-19 vaccine (dose 1, manufacturer unknown), for covid-19 immunisation; covid-19 vaccine (dose 2, manufacturer unknown), for covid-19 immunisation. the following information was reported: guillain-barre syndrome (life threatening) with onset 05feb2022, outcome "not recovered", described as "guillain-barre syndrome". the patient underwent the following laboratory tests and procedures: cerebro spinal fluid: (05feb2022) dissociation albumino-cytological. therapeutic measures were taken as a result of guillain-barre syndrome which included igev therapy (still in progress). clinical course details: onset of dysesthesia in the 4 limbs, subsequent motor impairment with ataxia of walking. at the test performed diagnosis of guillain-barre syndrome (dissociation albumino-cytological in cerebro spinal fluid). sender's comments: 16feb2022 local regulatory authority: asked to follow up on: vaccine lot number, medications taken by the patient due to hiv immunodeficiency. no follow-up attempts are possible; information about lot/batch number cannot be obtained. no further information is expected
- Lab Data
-
test date: 20220205; test name: cerebro spinal fluid; result unstructured data: test result:dissociation albumino-cytological
- List of symptoms
-
csf test guillain-barre syndrome
- 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