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VAERS Report 2156742

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: fk9706


Date de réception du rapport
2022-03-04
Date à laquelle le formulaire est complèté
Date de vaccination
2021-12-31
Date d’apparition
0
Nombre de jours (date d’apparition – date de vaccination)
0
Description de l’événement indésirable

unwell; milk allergy; primary immunisation: non-pfizer vaccine; booster: comirnaty; primary immunisation: non-pfizer vaccine; booster: comirnaty; this is a spontaneous report received from a contactable reporter(s) (consumer or other non healthcare professional) from the regulatory agency (ra). the reporter is the patient. regulatory number: gb-mhra-webcovid-202202151722537670-m5day (ra). other case identifier(s): gb-mhra-adr 26608012 (ra). a 47 year-old male patient received bnt162b2 (comirnaty), administration date 31dec2021 (lot number: fk9706) as dose 3 (booster), single for covid-19 immunisation. the patient's relevant medical history and concomitant medications were not reported. the patient had no symptoms associated with covid-19 and was not enrolled in clinical trial. vaccination history included: covid-19 vaccine (dose 2, manufacturer unknown), for covid-19 immunisation; covid-19 vaccine (dose 1, manufacturer unknown), for covid-19 immunisation. the following information was reported: off label use (medically significant), interchange of vaccine products (medically significant) all with onset 31dec2021, outcome "unknown" and all described as "primary immunisation: non-pfizer vaccine; booster: comirnaty"; malaise (medically significant), outcome "not recovered", described as "unwell"; milk allergy (medically significant) with onset 01jan2022, outcome "not recovered", described as "milk allergy". the patient underwent the following laboratory tests and procedures: sars-cov-2 test: negative. the patient had not tested positive for covid-19 since having the vaccine. the report of the patient was not related to possible inflammation of the heart (myocarditis or pericarditis). no follow-up attempts are needed. no further information is expected

Données de laboratoire
test name: covid-19 virus test; test result: negative
Liste des symptômes
malaise interchange of vaccine products sars-cov-2 test milk allergy 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