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VAERS Report 2136827

Case Report Section

Vaer Report Details

Age: NA

Gender: Female

State: Outside US

Patient Died?
No
Vaccine information

Name: COVID19 (COVID19 (PFIZER-BIONTECH))

Type: Coronavirus 2019 vaccine

Manufacturer: PFIZER

Lot: fd6840


Date report was received
2022-02-24
Date form completed
Date Vaccinated
2021-07-12
Date of Onset
106
Number of days (onset date – vaccination date)
106
Adverse Event Description

vaccination failure; sars-cov-2 infection; this is a spontaneous report received from a contactable reporter(s) (physician) from the regulatory authority-web. regulatory number: at-basgages-2022-009227. a 23 year-old female patient received bnt162b2 (comirnaty), intramuscular, administration date 12jul2021 (lot number: fd6840) as dose 2, single and intramuscular, administration date 07jun2021 (lot number: fc2473) as dose 1, single for covid-19 immunisation. the patient's relevant medical history and concomitant medications were not reported. the following information was reported: vaccination failure (medically significant) with onset 26oct2021, outcome "unknown", described as "vaccination failure"; covid-19 (medically significant) with onset 26oct2021, outcome "unknown", described as "sars-cov-2 infection". the patient underwent the following laboratory tests and procedures: sars-cov-2 test: (26oct2021) positive, notes: variant pcr-based: n.a., variant sequenced: n.a., n501y-positive: unknown. no follow-up attempts are possible. no further information is expected

Lab Data
test date: 20211026; test name: covid-19 pcr test; test result: positive ; comments: variant pcr-based: n.a. variant sequenced: n.a. n501y-positive: unknown
List of symptoms
covid-19 sars-cov-2 test vaccination failure
Patient Died?
No
Date Died
NA
Birth defect
false
Vaccine Administered By:
Other
Vaccine Purchased By:
Unknown
Patient visit ER?
No
Patient Hospitalized?
No
Stay in hospital
No
Days in hospital
Unspecified
Permanent disability?
No
Allergies:
na
Current Illness
na