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VAERS Report 2156710

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: unknown


Date de réception du rapport
2022-03-04
Date à laquelle le formulaire est complèté
Date de vaccination
2021-11-17
Date d’apparition
1
Nombre de jours (date d’apparition – date de vaccination)
1
Description de l’événement indésirable

anomaly heart; headache; brain freeze; tired out; tired eyes; chills; this is a spontaneous report received from a contactable reporter(s) (consumer or other non hcp) from the regulatory agency. regulatory number: gb-mhra-webcovid-202202141528158380-gken6. other case identifier(s): gb-mhra-adr 26602147. a 61 year-old male patient received bnt162b2 (comirnaty), administration date 17nov2021 (batch/lot number: unknown) as dose 3 (booster), single for covid-19 immunisation. the patient's relevant medical history and concomitant medications were not reported. patient has not had symptoms associated with covid-19. vaccination history included: bnt162b2 (dose 2), for covid-19 immunisation; bnt162b2 (dose 1), for covid-19 immunisation. the following information was reported: headache (medically significant) with onset 18nov2021, outcome "not recovered", described as "headache"; cold-stimulus headache (medically significant) with onset 18nov2021, outcome "not recovered", described as "brain freeze"; fatigue (medically significant) with onset 18nov2021, outcome "not recovered", described as "tired out"; asthenopia (medically significant) with onset 18nov2021, outcome "not recovered", described as "tired eyes"; chills (medically significant) with onset 18nov2021, outcome "recovering", described as "chills"; heart disease congenital (medically significant) with onset 23nov2021, outcome "recovered", described as "anomaly heart". the patient underwent the following laboratory tests and procedures: computerised tomogram head: unknown; sars-cov-2 test: no - negative covid-19 test. patient has not tested positive for covid-19 since having the vaccine. patient is not enrolled in clinical trial. no follow-up attempts are possible; information about lot/batch number cannot be obtained. no further information is expected

Données de laboratoire
test name: ct brain scan; result unstructured data: test result:unknown; test name: covid-19 virus test; result unstructured data: test result:no - negative covid-19 test
Liste des symptômes
chills fatigue headache heart disease congenital sars-cov-2 test computerised tomogram head asthenopia cold-stimulus headache
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