Détails du rapport Vaer
Âge: 12 ans
Genre: Female
Région : Outside US
- Patient décédé?
- Non
- Renseignements sur les vaccins
-
Nom: COVID19 (COVID19 (PFIZER-BIONTECH))
Type : Coronavirus 2019 vaccine
Fabricant: PFIZER
Lot: ff8288
- Date de réception du rapport
- 2022-03-04
- Date à laquelle le formulaire est complèté
- Date de vaccination
- 2021-10-20
- Date d’apparition
- 0
- Nombre de jours (date d’apparition – date de vaccination)
- 0
- Description de l’événement indésirable
-
allergic reaction similar to anaphylactic shock lasting about 3 hours. the vaccine, on the advice of the doctor, was administered in the clinic and the health personnel intervened promptly; allergic reaction similar to anaphylactic shock lasting about 3 hours. the vaccine, on the advice of the doctor, was administered in the clinic and the health personnel intervened promptly; this is a spontaneous report received from a contactable reporter(s) (consumer or other non hcp) from the regulatory authority-web. regulatory number: it-minisal02-846785. a 12 year-old female patient received bnt162b2 (comirnaty), intramuscular, administered in arm right, administration date 20oct2021 (lot number: ff8288) at the age of 12 years as dose 2, single for covid-19 immunisation. relevant medical history included: "allergy" (unspecified if ongoing), notes: allergy to various substances. the patient's concomitant medications were not reported. vaccination history included: covid-19 vaccine (dose 1, manufacturer unknown), for covid-19 immunization. the following information was reported: hypersensitivity (life threatening), anaphylactic shock (medically significant, life threatening) all with onset 20oct2021, outcome "recovered" and all described as "allergic reaction similar to anaphylactic shock lasting about 3 hours. the vaccine, on the advice of the doctor, was administered in the clinic and the health personnel intervened promptly". the patient underwent the following laboratory tests and procedures: impaired quality of life: 9/10. therapeutic measures were taken as a result of hypersensitivity, anaphylactic shock. reporter comment: allergy to various substances clinical course: actions taken (health personnel who administered life-saving drugs (intravenous cortisone) intervened).; reporter's comments: allergy to various substances
- Données de laboratoire
-
test name: impaired quality of life; result unstructured data: test result:9/10
- Liste des symptômes
-
impaired quality of life hypersensitivity anaphylactic shock
- 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