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VAERS Report 2156618

Case Report Section

Détails du rapport Vaer

Âge: N/A

Genre: Female

Région : Outside US

Patient décédé?
Non
Renseignements sur les vaccins

Nom: COVID19 (COVID19 (PFIZER-BIONTECH))

Type : Coronavirus 2019 vaccine

Fabricant: PFIZER

Lot: fe3380


Date de réception du rapport
2022-03-04
Date à laquelle le formulaire est complèté
Date de vaccination
2021-08-06
Date d’apparition
9
Nombre de jours (date d’apparition – date de vaccination)
9
Description de l’événement indésirable

anaphylactic reaction; this is a spontaneous report received from a contactable reporter(s) (consumer or other non hcp) from the regulatory authority (ra). the reporter is the patient. other case identifier(s): gb-mhra-vac-202202142206129470-rcso6, gb-mhra-adr 26604621. a 34 year-old female patient (not pregnant) received bnt162b2 (comirnaty), administration date 06aug2021 (lot number: fe3380) as dose number unknown, single for covid-19 immunisation. relevant medical history included: "urticaria chronic" (unknown if ongoing). patient is not currently breastfeeding. patient last menstrual period date was 20jan2022. concomitant medication(s) included: hydroxyzine hydrochloride taken for urticaria, start date: 01apr2010, stop date: 14feb2022. the following information was reported: anaphylactic reaction (medically significant, life threatening) with onset 15aug2021, outcome "recovered" (15aug2021), described as "anaphylactic reaction". the event "anaphylactic reaction" was evaluated at the emergency room visit. patient made it to a&e just in time before she stopped breathing. patient did not think that this reaction occurred as a result of a mistake made in the administration of the vaccine. no follow-up attempts are possible. no further information is expected

Données de laboratoire
na
Liste des symptômes
anaphylactic reaction
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