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VAERS Report 2136882

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: 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