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
- 2021-06-29
- Date d’apparition
- 2
- Nombre de jours (date d’apparition – date de vaccination)
- 2
- Description de l’événement indésirable
-
perimyocarditis; this is a spontaneous report received from a contactable reporter(s) (physician) from the regulatory authority-web. regulatory number: at-basgages-2021-077850. a 20 year-old male patient received bnt162b2 (comirnaty), administration date 29jun2021 (lot number: unknown) as dose 2, single for covid-19 immunisation. the patient had no relevant medical history. the patient's concomitant medications were not reported. vaccination history included: comirnaty (dose 1), for covid-19 immunization. the following information was reported: myocarditis (hospitalization, medically significant) with onset 01jul2021, outcome "recovered", described as "perimyocarditis". relatedness of drug to reaction was assessed by health care professional by assessment method. 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
-
myocarditis
- 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