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VAERS Report 2156903

Case Report Section

Détails du rapport Vaer

Âge: N/A

Genre: Unknown

Région : Outside US

Patient décédé?
Non
Renseignements sur les vaccins

Nom: COVID19 (COVID19 (PFIZER-BIONTECH))

Type : Coronavirus 2019 vaccine

Fabricant: PFIZER

Lot: fh0114


Date de réception du rapport
2022-03-04
Date à laquelle le formulaire est complèté
Date de vaccination
2021-11-05
Date d’apparition
0
Nombre de jours (date d’apparition – date de vaccination)
0
Description de l’événement indésirable

atrial fibrillation; primary immunisation: non-pfizer vaccine; booster: comirnaty; primary immunisation: non-pfizer vaccine; booster: comirnaty; this is a spontaneous report received from a contactable reporter (physician) from the regulatory agency. regulatory number: gb-mhra-webcovid-202202241734136430-sjbmx. other case identifier(s): gb-mhra-adr 26648355. a patient (no qualifiers provided) received bnt162b2 (comirnaty), administration date 05nov2021 (lot number: fh0114) as dose 3 (booster), single for covid-19 immunisation. the patient's relevant medical history and concomitant medications were not reported. patient did not have symptoms associated with covid-19. patient was not enrolled in clinical trial. vaccination history included: covid-19 vaccine (dose 2; manufacturer unknown), for covid-19 immunisation; covid-19 vaccine (dose 1; manufacturer unknown), for covid-19 immunisation. the following information was reported: off label use (medically significant), interchange of vaccine products (medically significant) all with onset 05nov2021, outcome "unknown" and all described as "primary immunisation: non-pfizer vaccine; booster: comirnaty"; atrial fibrillation (medically significant) with onset 22feb2022, outcome "not recovered", described as "atrial fibrillation". patient did not have a covid-19 test. no follow-up attempts are possible. no further information is expected

Données de laboratoire
na
Liste des symptômes
atrial fibrillation interchange of vaccine products 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?
Non
Allergies:
na
Maladie actuelle
na