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: fa1027
- Date report was received
- 2022-03-04
- Date form completed
- Date Vaccinated
- 2021-06-26
- Date of Onset
- 127
- Number of days (onset date – vaccination date)
- 127
- Adverse Event Description
-
covid-19 confirmed by positive covid-19 test; covid-19 confirmed by positive covid-19 test; this is a spontaneous report received from a contactable reporter(s) (consumer or other non hcp) from the ra. aa 48 year-old female patient (not pregnant) received bnt162b2 (bnt162b2), administration date 26jun2021 (lot number: fa1027) as dose 2, single and administration date 25may2021 (lot number: et8885) as dose 1, single for covid-19 immunisation. the patient's relevant medical history and concomitant medications were not reported. patient was not currently breastfeeding. the patient's concomitant medications were not reported. patient last menstrual period date was 10feb2022. the following information was reported: vaccination failure (medically significant), covid-19 (medically significant) all with onset 31oct2021, outcome "recovered" (08nov2021) and all described as "covid-19 confirmed by positive covid-19 test". the patient underwent the following laboratory tests and procedures: sars-cov-2 test: (31oct2021) yes - positive covid-19 test. no follow-up attempts are possible. no further information is expected.; sender's comments: linked report(s) : gb-pfizer inc-202200298715 same patient/product, different dose/events; gb-pfizer inc-202200348146 same patient/product, different dose/events
- Lab Data
-
test date: 20211031; test name: covid-19 virus test; result unstructured data: test result:yes - positive covid-19 test
- 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