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VAERS Report 2136743

Case Report Section

Détails du rapport Vaer

Âge: N/A

Genre: Female

Région : Outside US

Patient décédé?
Non
Renseignements sur les vaccins

Nom: COVID19 (COVID19 (PFIZER-BIONTECH))

Type : Coronavirus 2019 vaccine

Fabricant: PFIZER

Lot: 1f100ba


Date de réception du rapport
2022-02-24
Date à laquelle le formulaire est complèté
Date de vaccination
2021-12-17
Date d’apparition
1
Nombre de jours (date d’apparition – date de vaccination)
1
Description de l’événement indésirable

presyncope; fatigue; cardiac dysfunction; nausea; generalized joint pain; headache; myalgia; malaise; injection site pain; this is a spontaneous report received from a contactable reporter (consumer) from the regulatory authority. regulatory number: nl-lrb-00737803. a 72 year-old female patient received bnt162b2 (comirnaty), administration date 17dec2021 (lot number: 1f100ba) as dose 3 (booster), 0.3 ml single for covid-19 immunisation. relevant medical history included: "chronic lyme" (unspecified if ongoing), notes: confounding factors. the patient's concomitant medications were not reported. vaccination history included: comirnaty (1st single dose at 0.3 ml), administration date: 25apr2021, for covid-19 immunisation, reaction(s): "flu"; comirnaty (2nd single dose at 0.3 ml), administration date: 30may2021, for covid-19 immunisation, reaction(s): "flu". the following information was reported: cardiac dysfunction (medically significant) with onset 20dec2021, outcome "recovering", described as "cardiac dysfunction"; nausea (non-serious) with onset 18dec2021, outcome "recovering", described as "nausea"; arthralgia (non-serious) with onset 18dec2021, outcome "recovered" (19dec2021), described as "generalized joint pain"; headache (non-serious) with onset 18dec2021, outcome "recovering", described as "headache"; presyncope (non-serious) with onset 24dec2021, outcome "not recovered", described as "presyncope"; fatigue (non-serious) with onset 24dec2021, outcome "not recovered", described as "fatigue"; myalgia (non-serious) with onset 18dec2021, outcome "recovered" (19dec2021), described as "myalgia"; malaise (non-serious) with onset 18dec2021, outcome "not recovered", described as "malaise"; vaccination site pain (non-serious) with onset 18dec2021, outcome "recovered" (18dec2021), described as "injection site pain". the patient underwent the following laboratory tests and procedures: blood test: unknown results; electrocardiogram: unknown results; pulmonary imaging procedure: unknown results. no follow-up attempts are possible. no further information is expected

Données de laboratoire
test name: blood test; result unstructured data: test result:unknown results; test name: ecg; result unstructured data: test result:unknown results; test name: lung photos; result unstructured data: test result:unknown results
Liste des symptômes
investigation malaise fatigue nausea headache arthralgia myalgia electrocardiogram presyncope vaccination site pain blood test cardiac dysfunction
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