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VAERS Report 2156829

Case Report Section

Détails du rapport Vaer

Âge: 12 ans

Genre: Male

Région : Outside US

Patient décédé?
Non
Renseignements sur les vaccins

Nom: COVID19 (COVID19 (PFIZER-BIONTECH))

Type : Coronavirus 2019 vaccine

Fabricant: PFIZER

Lot: fl9994


Date de réception du rapport
2022-03-04
Date à laquelle le formulaire est complèté
Date de vaccination
2022-02-16
Date d’apparition
0
Nombre de jours (date d’apparition – date de vaccination)
0
Description de l’événement indésirable

axillary lump; armpit pain; fatigue; inappropriate schedule of vaccine administered; this is a spontaneous report received from a contactable reporter(s) (consumer or other non hcp) from the regulatory agency (ra). regulatory number: gb-mhra-webcovid-202202181552298920-gecl7 (ra). other case identifier(s): gb-mhra-adr 26621346 (ra). a 12 year-old male patient received bnt162b2 (comirnaty), administration date 16feb2022 (lot number: fl9994) at the age of 12 years as dose 2, single for covid-19 immunisation. relevant medical history included: "benign hypermobility" (unspecified if ongoing). patient has not had symptoms associated with covid-19. not had a covid-19 test. patient is not enrolled in clinical trial. the patient's concomitant medications were not reported. vaccination history included: comirnaty (dose 1), administration date: 18nov2021, for covid-19 immunization. the following information was reported: axillary mass (medically significant) with onset 18feb2022, outcome "not recovered", described as "axillary lump"; axillary pain (medically significant) with onset 18feb2022, outcome "not recovered", described as "armpit pain"; fatigue (medically significant) with onset 16feb2022, outcome "not recovered", described as "fatigue"; inappropriate schedule of product administration (non-serious) with onset 16feb2022, outcome "unknown", described as "inappropriate schedule of vaccine administered". the report does not relate to possible inflammation of the hear (myocarditis or pericarditis). patient has not tested positive for covid-19 since having the vaccine. no follow-up attempts are possible. no further information is expected

Données de laboratoire
na
Liste des symptômes
fatigue axillary pain inappropriate schedule of product administration axillary mass
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