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: 1f1016a
- Date de réception du rapport
- 2022-03-04
- Date à laquelle le formulaire est complèté
- Date de vaccination
- 2021-11-17
- Date d’apparition
- 91
- Nombre de jours (date d’apparition – date de vaccination)
- 91
- Description de l’événement indésirable
-
abdominal aortic aneurysm and positivity to sars cov 2 in vaccinated with 3rd dose; abdominal aortic aneurysm and positivity to sars cov 2 in vaccinated with 3rd dose; abdominal aortic aneurysm and positivity to sars cov 2 in vaccinated with 3rd dose; this is a spontaneous report received from a contactable reporter(s) (physician) from the regulatory authority-web and product quality group. regulatory number: it-minisal02-846301. a 77 year-old male patient received bnt162b2 (comirnaty), intramuscular, administered in arm left, administration date 17nov2021 08:50 (lot number: 1f1016a, expiration date: 30apr2022) as dose 3 (booster), 0.3 ml, single for covid-19 immunisation. the patient's relevant medical history and concomitant medications were not reported. vaccination history included: covid-19 vaccine (dose 1, manufacturer unknown), for covid-19 immunisation; covid-19 vaccine (dose 2, manufacturer unknown), for covid-19 immunisation. the following information was reported: covid-19 (medically significant, life threatening), drug ineffective (medically significant, life threatening), aortic aneurysm (life threatening) all with onset 16feb2022, outcome "recovering" and all described as "abdominal aortic aneurysm and positivity to sars cov 2 in vaccinated with 3rd dose". the patient underwent the following laboratory tests and procedures: sars-cov-2 test: (18feb2022) positive. no follow-up attempts are needed. no further information is expected
- Données de laboratoire
-
test date: 20220218; test name: covid-19 pcr test; result unstructured data: test result:positive
- Liste des symptômes
-
drug ineffective covid-19 sars-cov-2 test aortic aneurysm
- 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