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VAERS Report 2157023

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: fk9707


Date de réception du rapport
2022-03-04
Date à laquelle le formulaire est complèté
Date de vaccination
2021-12-15
Date d’apparition
73
Nombre de jours (date d’apparition – date de vaccination)
73
Description de l’événement indésirable

covid-19 positive test by lft; covid-19 positive test by lft; this is a spontaneous report received from contactable consumer from product quality and a sales representative. the reporter is the patient. a male patient received bnt162b2 (comirnaty, solution for injection), intramuscular, administered in arm left, administration date 15dec2021 12:00 (lot number: fk9707) as dose 3 (booster), single; intramuscular, administered in arm left, administration date 24may2021 12:00 (lot number: et1831) as dose 2, single; and intramuscular, administered in arm left, administration date 04may2021 12:00 (lot number: et3620) as dose 1, single for covid-19 immunisation. the patient's relevant medical history was not reported. there were no concomitant medications (no other vaccines within 4 weeks prior to the covid vaccine and other medications received within 2 weeks of vaccination). the following information was reported: vaccination failure (medically significant) with onset 26feb2022 08:00, outcome "unknown", covid-19 (medically significant) with onset 26feb2022 08:00, outcome "not recovered" and all described as "covid-19 positive test by lft". the patient underwent the following laboratory tests and procedures: sars-cov-2 test: (26feb2022) positive, notes: nasal swab. therapeutic measures were not taken as a result of covid-19. no follow-up attempts are possible. no further information is expected.; sender's comments: linked report(s) : gb-pfizer inc-2021611909 same patient/suspect drug, different dose number/event;gb-pfizer inc-202101819200 same patient/suspect drug, different dose number/event

Données de laboratoire
test date: 20220226; test name: lft; test result: positive ; comments: nasal swab
Liste des symptômes
covid-19 sars-cov-2 test vaccination failure
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