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VAERS Report 2157436

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: acb8491


Date de réception du rapport
2022-03-04
Date à laquelle le formulaire est complèté
Date de vaccination
2022-01-20
Date d’apparition
5
Nombre de jours (date d’apparition – date de vaccination)
5
Description de l’événement indésirable

laboratory confirmed covid-19; laboratory confirmed covid-19; ra this is a non-interventional study report from the regulatory authority-web and product quality group. a 44 year-old male patient received bnt162b2 (comirnaty), intramuscular, administration date 20jan2022 (lot number: acb8491) as dose 3 (booster), single, administration date 24aug2021 (lot number: fg6273) as dose 2, single and administration date 13jul2021 (lot number: ff0688) as dose 1, single for covid-19 immunisation. relevant medical history included: "alcoholism" (unknown if ongoing); "bilateral saphenectomy" (unknown if ongoing); "carotid thromboendarterectomy ", start date: 2021 (unknown if ongoing), notes: diagnosis in 2021; "hypertension arterial" (unknown if ongoing); "appendectomy" (unknown if ongoing). concomitant medications included: cardioaspirin; omeprazole; benerva; bisoprolol; atorvastatin; eskim. the following information was reported: covid-19 (medically significant), drug ineffective (medically significant) all with onset 25jan2022, outcome "unknown" and all described as "laboratory confirmed covid-19". the patient underwent the following laboratory tests and procedures: sars-cov-2 test: (25jan2022) positive, notes: swab. sender comment: the report came from the regulatory authority study. all the data in our possession have already been entered. the reporter's assessment of the causal relationship of the "laboratory confirmed covid-19" with the suspect product(s) bnt162b2 was not provided at the time of this report. since no determination has been received, the case is managed based on the company causality assessment. no follow-up attempts are possible. no further information is expected.; sender's comments: the efficacy of a drug varies from patient to patient and can be affected by different factors; however, a contributory role of the suspect product bnt162b2 to the reported drug ineffective / covid-19 cannot be ruled out.,linked report(s) : it-pfizer inc-202200307290 same patient/product, different dose/events

Données de laboratoire
test date: 20220125; test name: laboratory confirmed covid-19; test result: positive ; comments: swab
Liste des symptômes
drug ineffective covid-19 sars-cov-2 test
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