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VAERS Report 2156785

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: fj5782


Date de réception du rapport
2022-03-04
Date à laquelle le formulaire est complèté
Date de vaccination
2021-09-27
Date d’apparition
0
Nombre de jours (date d’apparition – date de vaccination)
0
Description de l’événement indésirable

palsy bells; dose 4; dose 4; this is a spontaneous report received from a contactable reporter(s) (physician) from the regulatory authority (ra). regulatory number: gb-mhra-webcovid-202202162339088240-vubzn (ra). other case identifier(s): gb-mhra-adr 26611796 (ra). a 44 year-old female patient (not pregnant) received bnt162b2 (comirnaty), administration date 27sep2021 (lot number: fj5782) as dose 4 (booster), single for covid-19 immunisation. relevant medical history included: "type 2 diabetes" (unspecified if ongoing), notes: type 2 diabetes patient has not had symptoms associated with covid-19 patient is not pregnant, patient is not currently breastfeeding. the patient's concomitant medications were not reported. vaccination history included: bnt162b2 (dose 1), administration date: 20dec2020, for covid-19 immunisation; bnt162b2 (dose 2), administration date: 07jan2021, for covid-19 immunisation; bnt162b2 (dose 3), administration date: 25mar2021, for covid-19 immunisation. the following information was reported: off label use (medically significant), immunisation (medically significant) all with onset 27sep2021, outcome "unknown" and all described as "dose 4"; bell's palsy (medically significant) with onset 11feb2022, outcome "not recovered", described as "palsy bells". the patient underwent the following laboratory tests and procedures: sars-cov-2 test: (13feb2022) negative, notes: no - negative covid-19 test; varicella zoster virus infection: (unspecified date) negative. clinical course: patient has not been tested positive for covid-19 since having the vaccine. unsure if patient was enrolled in clinical trial. this report did not relate to possible blood clots or low platelet counts and possible myocarditis or pericarditis. no follow-up attempts are possible. no further information is expected

Données de laboratoire
test date: 20220213; test name: covid-19 virus test; test result: negative ; comments: no - negative covid-19 test; test name: vzv igm; test result: negative
Liste des symptômes
sars-cov-2 test immunisation varicella zoster virus infection off label use bell's palsy
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