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VAERS Report 2136708

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: fd0785


Date de réception du rapport
2022-02-24
Date à laquelle le formulaire est complèté
Date de vaccination
2021-06-07
Date d’apparition
51
Nombre de jours (date d’apparition – date de vaccination)
51
Description de l’événement indésirable

polymyalgia rheumatica; fatigue; malaise; generalized joint pain; myalgia; this is a spontaneous report received from a contactable reporter(s) (consumer or other non hcp) from the regulatory authority-web. regulatory number: nl-lrb-00724347 (ra). other case identifier(s): nl-lrb-00791130 (ra). a 66 year-old male patient received bnt162b2 (comirnaty), administration date 07jun2021 (lot number: fd0785) as dose 2, 0.3 ml single for covid-19 immunisation. the patient's relevant medical history was not reported. concomitant medication(s) included: acetylsalicylzuur (tablet, 30 mg (milligram), disper); crestor (tablet, 10 mg (milligram), filmomhuld). vaccination history included: comirnaty (dose 1, single, strength 0.3 ml, batch/lot number: unknown), administration date: 03may2021, for covid-19 immunisation. the following information was reported: polymyalgia rheumatica (medically significant) with onset 28jul2021, outcome "recovering", described as "polymyalgia rheumatica"; fatigue (non-serious) with onset 28jul2021, outcome "recovering", described as "fatigue"; malaise (non-serious) with onset 28jul2021, outcome "recovering", described as "malaise"; arthralgia (non-serious) with onset 28jul2021, outcome "recovering", described as "generalized joint pain"; myalgia (non-serious) with onset 28jul2021, outcome "recovering", described as "myalgia". no follow-up attempts are possible. no further information is expected. follow-up 1 (14feb2022): this is a spontaneous follow-up report from the same contactable consumer: updated information: the llt for the event 'muscular rheumatism' updated to 'polymyalgia rheumatica'. new reference number added, historical vaccine notes and ongoing was updated as no, biological product, suspect dose number, dose and unit (0.3 ml), dose description for concomitant medications and updated narrative accordingly. no follow-up attempts are possible. no further information is expected

Données de laboratoire
na
Liste des symptômes
malaise fatigue polymyalgia rheumatica arthralgia myalgia
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