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VAERS Report 2156807

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: fk9413


Date de réception du rapport
2022-03-04
Date à laquelle le formulaire est complèté
Date de vaccination
2021-11-20
Date d’apparition
0
Nombre de jours (date d’apparition – date de vaccination)
0
Description de l’événement indésirable

hair loss; off label use; interchange of vaccine products; this is a spontaneous report received from a contactable reporter(s) (pharmacist) from the regulatory authority(ra). regulatory number: gb-mhra-webcovid-202202171617407840-3wazm (ra). other case identifier(s): gb-mhra-adr 26614055 (ra). a 73-year-old male patient received bnt162b2 (comirnaty), administration date 20nov2021 (lot number: fk9413) as dose 3 (booster), single for covid-19 immunisation. relevant medical history included: "osteoarthritis" (unspecified if ongoing); "hypertension" (unspecified if ongoing); "high cholesterol" (unspecified if ongoing). the patient's concomitant medications were not reported. vaccination history included: covid-19 vaccine astrazeneca (dose number unknown, single), administration date: 02jul2021, for covid-19 immunisation; covid-19 vaccine (dose number unknown, manufacturer unknown), for covid-19 immunisation. the following information was reported: off label use (disability) with onset 20nov2021, described as "off label use"; interchange of vaccine products (disability) with onset 20nov2021, described as "interchange of vaccine products"; alopecia (disability) with onset 30nov2021, outcome "not recovered", described as "hair loss". the patient underwent the following laboratory tests and procedures: sars-cov-2 test: negative, notes: no - negative covid-19 test. clinical course: patient has not had symptoms associated with covid-19. patient has not tested positive for covid-19 since having the vaccine. patient is not enrolled in clinical trial. the report does not relate to possible blood clots or low platelet counts or to possible myocarditis or pericarditis. no follow-up attempts are possible. no further information is expected

Données de laboratoire
test name: covid-19 virus test; test result: negative ; comments: no - negative covid-19 test
Liste des symptômes
alopecia interchange of vaccine products sars-cov-2 test 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?
Oui
Allergies:
na
Maladie actuelle
na