Page breadcrumb nav

VAERS Report 2156797

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: em4965


Date de réception du rapport
2022-03-04
Date à laquelle le formulaire est complèté
Date de vaccination
2021-04-25
Date d’apparition
0
Nombre de jours (date d’apparition – date de vaccination)
0
Description de l’événement indésirable

tia; central retinal vein occlusion; inappropriate schedule of vaccine administered; this is a spontaneous report received from a contactable reporter(s) (consumer or other non hcp) from the regulatory authority. regulatory number: gb-mhra-webcovid-202202171239418250-imiht (ra). other case identifier(s): gb-mhra-adr 26612635 (ra). a 65 year-old male patient received bnt162b2 (pfizer-biontech covid-19 vaccine, solution for injection), administration date 25apr2021 (lot number: em4965) as dose 2, single for covid-19 immunisation. relevant medical history included: "prostate cancer", start date: sep2015 (unspecified if ongoing); "pituitary tumour benign" (unspecified if ongoing); "pituitary cyst" (unspecified if ongoing); "brachytherapy to prostate" (unspecified if ongoing); "prostate cancer nos" (unspecified if ongoing). it was also reported that the benign pituitary tumor was currently being monitored. the prostate cancer in sep2015 was treated by brachytherapy. the patient has not had symptoms associated with covid-19, has not tested positive for covid-19 since having the vaccine and is not enrolled in clinical trial. concomitant medications included: cabergoline taken for pituitary tumour benign, start date: 01jan2010; levothyroxine taken for pituitary cyst, start date: 01jan2010; sildenafil taken for brachytherapy to prostate, start date: 10oct2015; tamsulosin taken for prostate cancer, start date: 15sep2015; tostran taken for pituitary tumour benign, start date: 01jan2010. vaccination history included: bnt162b2 (dose 1; batch/lot number: er1471), administration date: 25feb2021, for covid-19 immunisation. the following information was reported: retinal vein occlusion (disability, medically significant) with onset 12aug2021, outcome "recovering", described as "central retinal vein occlusion"; transient ischaemic attack (disability, medically significant), outcome "unknown", described as "tia"; inappropriate schedule of product administration (non-serious) with onset 25apr2021, outcome "unknown", described as "inappropriate schedule of vaccine administered". central retinal vein occlusion may have been caused by a tia, no other symptoms from tia. the patient underwent the following laboratory tests and procedures: blood test: (17sep2021) unknown results; computerised tomogram head: (17sep2021) unknown results; heart rate: (17sep2021) unknown results; sars-cov-2 test: (unspecified date) negative; ultrasound doppler: (17sep2021) unknown results. no follow-up attempts are possible. no further information is expected

Données de laboratoire
test date: 20210917; test name: blood tests; result unstructured data: test result:unknown results; test date: 20210917; test name: head ct scan; result unstructured data: test result:unknown results; test date: 20210917; test name: heart monitor; result unstructured data: test result:unknown results; test name: covid-19 virus test; test result: negative ; test date: 20210917; test name: doppler scan on carotid artery; result unstructured data: test result:unknown results
Liste des symptômes
ultrasound doppler inappropriate schedule of product administration retinal vein occlusion sars-cov-2 test transient ischaemic attack blood test computerised tomogram head heart rate
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?
Oui
Allergies:
na
Maladie actuelle
na