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VAERS Report 2157402

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: fk6304


Date report was received
2022-03-04
Date form completed
Date Vaccinated
2022-01-20
Date of Onset
0
Number of days (onset date – vaccination date)
0
Adverse Event Description

acute pericarditis. burning chest pain that is accentuated by supine and with breathing; acute pericarditis. burning chest pain that is accentuated by supine and with breathing; off label use; interchange of vaccine products (dose 2: spikevax); this is a spontaneous report received from a contactable reporter(s) (physician) from the regulatory authority-web. regulatory number: it-minisal02-845399. a 28 year-old female patient received bnt162b2 (comirnaty), intramuscular, administered in arm left, administration date 20jan2022 17:52 (lot number: fk6304) as dose 3 (booster), 0.3 ml single for covid-19 immunisation; covid-19 vaccine mrna (mrna 1273) (spikevax), administration date 31aug2021 (batch/lot number: unknown) 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 immunisation. the following information was reported: off label use (medically significant) with onset 20jan2022, outcome "unknown", described as "off label use"; interchange of vaccine products (medically significant) with onset 20jan2022, outcome "unknown", described as "interchange of vaccine products (dose 2: spikevax)"; pericarditis (medically significant), chest pain (medically significant) all with onset 13feb2022, outcome "not recovered" and all described as "acute pericarditis. burning chest pain that is accentuated by supine and with breathing". the patient underwent the following laboratory tests and procedures: electrocardiogram: (14feb2022) results unknown. therapeutic measures were taken as a result of pericarditis and chest pain. reporter comment: acute pericarditis 24 days after vaccine administration. similar episode 1 month after the second dose.; reporter's comments: acute pericarditis 24 days after vaccine administration. similar episode 1 month after the second dose

Lab Data
test date: 20220214; test name: ecg; result unstructured data: test result:results unknown
List of symptoms
chest pain pericarditis interchange of vaccine products electrocardiogram off label use
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