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VAERS Report 2157410

Case Report Section

Détails du rapport Vaer

Âge: N/A

Genre: Male

Région : Outside US

Patient décédé?
Non
Renseignements sur les vaccins

Nom: COVID19 (COVID19 (PFIZER-BIONTECH))

Type : Coronavirus 2019 vaccine

Fabricant: PFIZER

Lot: 1f1016a


Date de réception du rapport
2022-03-04
Date à laquelle le formulaire est complèté
Date de vaccination
2021-11-17
Date d’apparition
91
Nombre de jours (date d’apparition – date de vaccination)
91
Description de l’événement indésirable

abdominal aortic aneurysm and positivity to sars cov 2 in vaccinated with 3rd dose; abdominal aortic aneurysm and positivity to sars cov 2 in vaccinated with 3rd dose; abdominal aortic aneurysm and positivity to sars cov 2 in vaccinated with 3rd dose; this is a spontaneous report received from a contactable reporter(s) (physician) from the regulatory authority-web and product quality group. regulatory number: it-minisal02-846301. a 77 year-old male patient received bnt162b2 (comirnaty), intramuscular, administered in arm left, administration date 17nov2021 08:50 (lot number: 1f1016a, expiration date: 30apr2022) as dose 3 (booster), 0.3 ml, 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; covid-19 vaccine (dose 2, manufacturer unknown), for covid-19 immunisation. the following information was reported: covid-19 (medically significant, life threatening), drug ineffective (medically significant, life threatening), aortic aneurysm (life threatening) all with onset 16feb2022, outcome "recovering" and all described as "abdominal aortic aneurysm and positivity to sars cov 2 in vaccinated with 3rd dose". the patient underwent the following laboratory tests and procedures: sars-cov-2 test: (18feb2022) positive. no follow-up attempts are needed. no further information is expected

Données de laboratoire
test date: 20220218; test name: covid-19 pcr test; result unstructured data: test result:positive
Liste des symptômes
drug ineffective covid-19 sars-cov-2 test aortic aneurysm
Patient décédé?
Non
Date de décès
N/A
Anomalie congénitale
false
Vaccin administré par :
Other
Vaccin acheté par :
Inconnu
Visite d’un patient à l’urgence?
Non
Patient hospitalisé?
Non
Séjour à l’hôpital
Non
Nombre de jours à l’hôpital
Non spécifié
Invalidité permanente?
Non
Allergies:
na
Maladie actuelle
na