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VAERS Report 2157388

Case Report Section

Détails du rapport Vaer

Âge: 54 ans

Genre: Female

Région : Outside US

Patient décédé?
Renseignements sur les vaccins


Type : Coronavirus 2019 vaccine

Fabricant: PFIZER

Lot: fe7010

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

sensation of stiffness in the movement of the right eye,; paresthesia on the right side of the body; severe headache; instability in coordination; instability in coordination; dizziness; this is a spontaneous report received from a contactable reporter(s) (other hcp) from the regulatory authority. regulatory number: it-minisal02-844263 (ra). a 54 year-old female patient received bnt162b2 (comirnaty), intramuscular, administered in deltoid left, administration date 13jul2021 17:11 (lot number: fe7010, expiration date: 31jan2022) at the age of 54 years as dose 2, single for covid-19 immunisation. the patient's relevant medical history and concomitant medications were not reported. vaccination history included: covid-19 vaccine (dose 1, manufacturer unknown), for covid-19 immunization. the following information was reported: eye pain (medically significant) with onset 13jul2021, outcome "recovering", described as "sensation of stiffness in the movement of the right eye,"; paraesthesia (non-serious) with onset 13jul2021, outcome "recovering", described as "paresthesia on the right side of the body"; headache (non-serious) with onset 13jul2021, outcome "recovering", described as "severe headache"; vertigo (non-serious), coordination abnormal (non-serious) all with onset 13jul2021, outcome "recovering" and all described as "instability in coordination"; dizziness (non-serious) with onset 13jul2021, outcome "recovering", described as "dizziness". the events "sensation of stiffness in the movement of the right eye,", "paresthesia on the right side of the body", "severe headache" and "instability in coordination" were evaluated at the physician office visit. the patient underwent the following laboratory tests and procedures: magnetic resonance imaging: (29sep2021) unknown results; neurological examination: (24jan2022) unknown results. reporter comment: inoculation site: left deltoid. sender comment: 16feb2022 local center of pharmacovigilance: requested follow-up regarding: visit reports and diagnostic tests follow-up attempts are completed. no further information is expected.; reporter's comments: inoculation site: left deltoid

Données de laboratoire
test date: 20210929; test name: mri with contrast medium and without; result unstructured data: test result:unknown results; test date: 20220124; test name: neurological examination; result unstructured data: test result:unknown results
Liste des symptômes
paraesthesia headache dizziness coordination abnormal eye pain vertigo magnetic resonance imaging neurological examination
Patient décédé?
Date de décès
Anomalie congénitale
Vaccin administré par :
Vaccin acheté par :
Visite d’un patient à l’urgence?
Patient hospitalisé?
Séjour à l’hôpital
Nombre de jours à l’hôpital
Non spécifié
Invalidité permanente?
Maladie actuelle