Détails du rapport Vaer
Âge: N/A
Genre: Male
Région : Outside US
- Patient décédé?
- Non
- Renseignements sur les vaccins
-
Nom: COVID19 (COVID19 (PFIZER-BIONTECH))
Type : Coronavirus 2019 vaccine
Fabricant: PFIZER
Lot: fd1921
- Date de réception du rapport
- 2022-02-24
- Date à laquelle le formulaire est complèté
- Date de vaccination
- 2021-06-11
- Date d’apparition
- 139
- Nombre de jours (date d’apparition – date de vaccination)
- 139
- Description de l’événement indésirable
-
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-2022-015077 (ra). a 57 year-old male patient received bnt162b2 (comirnaty), intramuscular, administration date 11jun2021 (lot number: fd1921) as dose 2, single and intramuscular, administration date 30apr2021 (lot number: ey3014) 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 28oct2021, outcome "unknown", described as "vaccination failure"; covid-19 (medically significant) with onset 28oct2021, outcome "unknown", described as "sars-cov-2 infection". the patient underwent the following laboratory tests and procedures: sars-cov-2 test: (28oct2021) positive, notes: variant pcr-based: b.1.617.2. variant sequenced: n.a. n501y-positive: no. no follow-up attempts are possible. no further information is expected.; sender's comments: linked report(s) : at-pfizer inc-202200289286 same reporter, same patient, different dose of the vaccine, different event
- Données de laboratoire
-
test date: 20211028; test name: covid-19 pcr test; test result: positive ; comments: variant pcr-based: b.1.617.2 variant sequenced: n.a. n501y-positive: no
- Liste des symptômes
-
drug ineffective covid-19 sars-cov-2 test
- 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?
- Non
- Séjour à l’hôpital
- Non
- Nombre de jours à l’hôpital
- Non spécifié
- Invalidité permanente?
- Non
- Allergies:
-
na
- Maladie actuelle
-
na