Page breadcrumb nav

VAERS Report 2156684

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: fk0596


Date de réception du rapport
2022-03-04
Date à laquelle le formulaire est complèté
Date de vaccination
2021-12-06
Date d’apparition
0
Nombre de jours (date d’apparition – date de vaccination)
0
Description de l’événement indésirable

hives giant/large hives; off label use; interchange of vaccine products; this is a spontaneous report received from contactable reporter(s) (consumer or other non hcp) from the ra-web. the reporter is the patient. regulatory number: gb-mhra-webcovid-202202111759309700-akstf. other case identifier(s): gb-mhra-adr 26594458. a 62 year-old male patient received bnt162b2 (comirnaty), administration date 06dec2021 (lot number: fk0596) as dose 3 (booster), single for covid-19 immunisation. relevant medical history included: "blood pressure abnormal" (unspecified if ongoing), notes: all i take is one blood pressure tablet. patient has not had symptoms associated with covid-19. the patient's concomitant medications were not reported. vaccination history included: covid-19 vaccine (dose 1; manufacturer unknown), for covid-19 immunization; covid-19 vaccine (dose 2; manufacturer unknown), for covid-19 immunization. the following information was reported: off label use (medically significant) with onset 06dec2021, outcome "unknown", described as "off label use"; interchange of vaccine products (medically significant) with onset 06dec2021, outcome "unknown", described as "interchange of vaccine products"; angioedema (medically significant) with onset 12dec2021, outcome "not recovered", described as "hives giant/large hives". clinical course: patient experienced large hives, on ankles, wrists, shins, back of knees. now moved to neck back and top of ears and along jaw line. patient has not tested positive for covid-19 since having the vaccine. patient is not enrolled in clinical trial. the report was not related to possible inflammation of the heart (myocarditis or pericarditis). the patient underwent the following laboratory tests and procedures: sars-cov-2 test: negative, notes: no - negative covid-19 test. no follow-up attempts are possible. no further information is expected

Données de laboratoire
test name: covid-19 virus test; test result: negative ; comments: no - negative covid-19 test
Liste des symptômes
interchange of vaccine products sars-cov-2 test angioedema off label use
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