Page breadcrumb nav

VAERS Report 2136795

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: unknown


Date de réception du rapport
2022-02-24
Date à laquelle le formulaire est complèté
Date de vaccination
2021-11-19
Date d’apparition
0
Nombre de jours (date d’apparition – date de vaccination)
0
Description de l’événement indésirable

optic neuritis (triggered by an multiple sclerosis flare-up); optic neuritis (triggered by an multiple sclerosis flare-up); off label use; interchange of vaccine products (d1, d2: moderna); this is a spontaneous report received from a contactable reporter(s) (consumer or other non hcp) from the regulatory authority web. the reporter is the patient. regulatory number: at-basgages-2021-077780 a 33 year-old male patient received bnt162b2 (comirnaty), administration date 19nov2021 (batch/lot number: unknown) as dose 3 (booster), single for covid-19 immunisation. relevant medical history included: "multiple sclerosis" (unspecified if ongoing); "asthma bronchial" (unspecified if ongoing). the patient's concomitant medications were not reported. vaccination history included: covid-19 vaccine moderna (dose 1), for covid-19 immunisation; covid-19 vaccine moderna (dose 2), for covid-19 immunisation. the following information was reported: off label use (hospitalization) with onset 19nov2021, outcome "unknown", described as "off label use"; interchange of vaccine products (hospitalization) with onset 19nov2021, outcome "unknown", described as "interchange of vaccine products (d1, d2: moderna)"; optic neuritis (hospitalization), multiple sclerosis relapse (hospitalization) all with onset 05dec2021, outcome "not recovered" and all described as "optic neuritis (triggered by an multiple sclerosis flare-up)". health authority comment: the report is for myself. no follow-up attempts are possible; information about lot/batch number cannot be obtained. no further information is expected

Données de laboratoire
na
Liste des symptômes
optic neuritis interchange of vaccine products off label use multiple sclerosis relapse
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?
Oui
Séjour à l’hôpital
Non
Nombre de jours à l’hôpital
Non spécifié
Invalidité permanente?
Non
Allergies:
na
Maladie actuelle
na