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
- 2022-01-26
- Date of Onset
- 16
- Number of days (onset date – vaccination date)
- 16
- Adverse Event Description
-
drug ineffective; symptomatic contagion from sars cov 2 in subjects undergoing a full cycle plus booster dose; this is a spontaneous report received from a contactable reporter(s) (physician). the reporter is the patient. a male patient received bnt162b2 (comirnaty), administration date 26jan2022 (batch/lot number: unknown) as dose 3 (booster), single, administration date 27sep2021 (batch/lot number: unknown) as dose 2, single and administration date 25jan2021 (batch/lot number: unknown) as dose 1, single for covid-19 immunisation. the patient's relevant medical history and concomitant medications were not reported. the following information was reported: drug ineffective (medically significant) with onset 11feb2022, outcome "unknown", described as "drug ineffective"; covid-19 (medically significant) with onset 11feb2022, outcome "unknown", described as "symptomatic contagion from sars cov 2 in subjects undergoing a full cycle plus booster dose". the lot number for bnt162b2 was not provided and will be requested during follow up.; sender's comments: based on the information in the case report, a possible causal relationship between the events and suspect drug bnt162b2 cannot be excluded.,linked report(s) : it-pfizer inc-202200350651 same reporter, patient and suspect vaccine, different suspect dose and ae
- Lab Data
-
na
- List of symptoms
-
drug ineffective covid-19
- 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