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VAERS Report 2136800

Case Report Section

Détails du rapport Vaer

Âge: 82 ans

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
2021-11-04
Date d’apparition
0
Nombre de jours (date d’apparition – date de vaccination)
0
Description de l’événement indésirable

lung pain; myalgia; arthralgia; partially mentally absent, decreased concentration; this is a spontaneous report received from a contactable reporter(s) (consumer or other non hcp) from the regulatory authority-web. regulatory number: at-basgages-2021-077953. a 82 year-old female patient received bnt162b2 (comirnaty), administration date 04nov2021 (batch/lot number: unknown) at the age of 82 years as dose 3 (booster), single for covid-19 immunisation. the patient's relevant medical history and concomitant medications were not reported. vaccination history included: comirnaty (dose 1, single.), for covid-19 immunisation; comirnaty (dose 2, single.), for covid-19 immunisation. the following information was reported: pulmonary pain (hospitalization) with onset 10dec2021, outcome "not recovered", described as "lung pain"; arthralgia (hospitalization) with onset 04nov2021, outcome "not recovered", described as "arthralgia"; myalgia (hospitalization) with onset 06dec2021, outcome "not recovered", described as "myalgia"; disturbance in attention (non-serious) with onset 10dec2021, outcome "not recovered", described as "partially mentally absent, decreased concentration". 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
arthralgia myalgia disturbance in attention pulmonary pain
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