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
- 2022-01-04
- Date d’apparition
- 22
- Nombre de jours (date d’apparition – date de vaccination)
- 22
- Description de l’événement indésirable
-
thrombophlebitis leg; disease recurrence; left superficial thrombophlebitis; this is a spontaneous report received from a contactable reporter(s) (other hcp) from the regulatory authority. regulatory number: gb-mhra-webcovid-202202171152307970-g3h0e. a 34 year-old male patient received bnt162b2 (comirnaty), administration date 04jan2022 (batch/lot number: unknown) as dose 3 (booster), single for covid-19 immunisation. relevant medical history included: "thrombophlebitis" (unspecified if ongoing). the patient's concomitant medications were not reported. vaccination history included: covid 19 vaccine (dose 2; manufactuerer unknown), for covid-19 immunisation; covid 19 vaccine (dose 1; manufactuerer unknown), for covid-19 immunisation. it was unsure if the patient had symptoms associated with covid-19. the patient did not undergo a covid-19 test. the patient was not enrolled in a clinical trial. the following information was reported: thrombophlebitis (medically significant) with onset 26jan2022, outcome "recovering", described as "thrombophlebitis leg"; disease recurrence (medically significant) with onset 26jan2022, outcome "recovering", described as "disease recurrence"; superficial vein thrombosis (medically significant) with onset 26jan2022, outcome "unknown", described as "left superficial thrombophlebitis". the patient underwent the following laboratory tests and procedures: ultrasound doppler: (26jan2022) unknown results. no follow-up attempts are possible; information about lot/batch number cannot be obtained. no further information is expected
- Données de laboratoire
-
test date: 20220126; test name: us doppler; result unstructured data: test result:unknown results
- Liste des symptômes
-
ultrasound doppler thrombophlebitis disease recurrence superficial vein thrombosis
- 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