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VAERS Report 2157387

Case Report Section

Vaer Report Details

Age: NA

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
2022-02-03
Date of Onset
0
Number of days (onset date – vaccination date)
0
Adverse Event Description

headache; vertigo; dose 2: 23sep2021 / dose 3: 03feb2022 = 134 days; this is a spontaneous report received from a contactable reporter(s) (physician) from the ra-web. regulatory number: it-minisal02-844245. a 13 year-old female patient received bnt162b2 (comirnaty), administered in arm left, administration date 03feb2022 (batch/lot number: unknown) as dose 3 (booster), single for covid-19 immunisation. the patient's relevant medical history and concomitant medications were not reported. vaccination history included: comirnaty (dose 1, single), administration date: 02sep2021, for covid-19 immunization; comirnaty (dose 2, single), administration date: 23sep2021, for covid-19 immunization. the following information was reported: headache (hospitalization) with onset 04feb2022, outcome "recovered" (15feb2022), described as "headache"; vertigo (hospitalization) with onset 04feb2022, outcome "recovering", described as "vertigo"; inappropriate schedule of product administration (non-serious) with onset 03feb2022, outcome "unknown", described as "dose 2: 23sep2021 / dose 3: 03feb2022 = 134 days". 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
headache vertigo inappropriate schedule of product administration
Patient Died?
No
Date Died
NA
Birth defect
false
Vaccine Administered By:
Other
Vaccine Purchased By:
Unknown
Patient visit ER?
No
Patient Hospitalized?
Yes
Stay in hospital
No
Days in hospital
Unspecified
Permanent disability?
No
Allergies:
na
Current Illness
na