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: fc0681
- Date report was received
- 2022-02-24
- Date form completed
- Date Vaccinated
- 2021-05-23
- Date of Onset
- 160
- Number of days (onset date – vaccination date)
- 160
- Adverse Event Description
-
vaccination failure; sars-cov-2 infection; this is a spontaneous report received from a contactable reporter(s) (physician) from a regulatory authority. regulatory number: at-basgages-2022-015018. a 40 year-old female patient received bnt162b2 (comirnaty), intramuscular, administration date 23may2021 (lot number: fc0681) as dose 2, single and intramuscular, administration date 11apr2021 (lot number: ew2246) as dose 1, single for covid-19 immunisation. the patient's relevant medical history was not reported. there were no concomitant medications. the following information was reported: drug ineffective (medically significant) with onset 30oct2021, outcome "unknown", described as "vaccination failure"; covid-19 (medically significant) with onset 30oct2021, outcome "unknown", described as "sars-cov-2 infection". the patient underwent the following laboratory tests and procedures: sars-cov-2 test: (30oct2021) positive, notes: pcr-based variant: n.a. variant sequenced: n.a. n501y-positive: unknown. no follow-up attempts are possible. no further information is expected.; sender's comments: linked report(s) : 202200294159 same patient/product, different dose/events
- Lab Data
-
test date: 20211030; test name: covid-19 pcr test; test result: positive ; comments: pcr-based variant: n.a. variant sequenced: n.a. n501y-positive: unknown
- List of symptoms
-
drug ineffective covid-19 sars-cov-2 test
- 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