Vaer Report Details
Age: 36 years old
Gender: Female
State: Outside US
- Patient Died?
- No
- Vaccine information
-
Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Type: Coronavirus 2019 vaccine
Manufacturer: PFIZER
Lot: unknown
- Date report was received
- 2022-03-04
- Date form completed
- Date Vaccinated
- 2021-07-15
- Date of Onset
- 0
- Number of days (onset date – vaccination date)
- 0
- Adverse Event Description
-
intense headache,frequent the first 15 days,decreased the next 15 days; vitiligo relapse 7 days since the first dose,other factors excluded; this is a spontaneous report received from a contactable reporter (consumer) from the regulatory authority-web. regulatory number: gr-greof-202108956 (ra). a 36-year-old female patient received bnt162b2 (comirnaty), administration date 15jul2021 (lot number: unknown) at the age of 36 years as dose 1, single for covid-19 immunisation. relevant medical history included: "thyroid gland (has autoimmune disease)" (unspecified if ongoing); "patient was a lactating woman" (unspecified if ongoing). the patient's concomitant medications were not reported. the following information was reported: headache (medically significant) with onset 15jul2021, outcome "recovered", described as "intense headache, frequent the first 15 days, decreased the next 15 days"; vitiligo (medically significant) with onset 15jul2021, outcome "unknown", described as "vitiligo relapse 7 days since the first dose, other factors excluded". clinical course: the patient was a lactating woman. no allergy. non-smoker, no drug abuse. the thyroid gland (has autoimmune disease) was not affected. no follow-up attempts are possible; information about lot/batch number cannot be obtained. no further information is expected
- Lab Data
-
na
- List of symptoms
-
headache vitiligo
- 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