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: unknown
- Date de réception du rapport
- 2022-02-24
- Date à laquelle le formulaire est complèté
- Date de vaccination
- 2021-12-01
- Date d’apparition
- 0
- Nombre de jours (date d’apparition – date de vaccination)
- 0
- Description de l’événement indésirable
-
deep vein thrombosis; pulmonary artery embolism; dyspnea in pulmonary artery embolism/deep vein thrombosis; inappropriate route of vaccination; this is a spontaneous report received from a contactable reporter(s) (physician) from the regulatory authority. regulatory number: at-basgages-2021-077870 (agency). other case identifier(s): at-pfizer inc-202200240083 (duplicate case). a 79 year-old female patient received bnt162b2 (comirnaty), subcutaneous, administration date 01dec2021 (batch/lot number: unknown) as dose 3 (booster), single for covid-19 immunisation. relevant medical history included: "varicosity" (unspecified if ongoing); "hypertension arterial" (ongoing). the patient's concomitant medications were not reported. vaccination history included: comirnaty (1st dose), for covid-19 immunization; comirnaty (2nd dose), for covid-19 immunization. the following information was reported: deep vein thrombosis (hospitalization, medically significant) with onset 18dec2021, outcome "recovered", described as "deep vein thrombosis"; pulmonary embolism (hospitalization, medically significant) with onset 18dec2021, outcome "recovered", described as "pulmonary artery embolism"; dyspnoea (hospitalization) with onset 18dec2021, outcome "recovered", described as "dyspnea in pulmonary artery embolism/deep vein thrombosis"; incorrect route of product administration (non-serious) with onset 01dec2021, outcome "unknown", described as "inappropriate route of vaccination". clinical course: relatedness of drug to reaction(s)/dyspnoea/ health care professional/ who assessment / possible. 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
-
dyspnoea incorrect route of product administration pulmonary embolism deep vein thrombosis
- 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
-
hypertension arterial