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VAERS Report 2157133

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: fj3438


Date report was received
2022-03-04
Date form completed
Date Vaccinated
2021-12-06
Date of Onset
3
Number of days (onset date – vaccination date)
3
Adverse Event Description

palpitations; anxiety; this is a spontaneous report received from a contactable reporter(s) (consumer or other non hcp) from the regulatory authority web. the reporter is the patient. regulatory number: ie-hpra-2022-091949. a 66-year-old female patient received bnt162b2 (comirnaty), administration date 06dec2021 (lot number: fj3438) as dose number unknown (booster), single for covid-19 immunisation. relevant medical history was not reported. there were no concomitant medications. vaccination history included: astra zeneca covid-19/vaxzevria (previous vac astra zeneca and no reaction. unknown dose. chimpanzee adenovirus encoding the sars cov 2 spike glycoprotein (chadox1-s)), for covid-19 immunisation. the following information was reported: palpitations (medically significant) with onset 09dec2021, outcome "recovered" (2022), described as "palpitations"; anxiety (medically significant) with onset 09dec2021, outcome "recovered" (2022), described as "anxiety". the events "palpitations" and "anxiety" were evaluated at the physician office visit. the patient underwent the following laboratory tests and procedures: investigation: unknown results. reporter commented: "went to gp and attended hospital for tests...palpations eased now but would be very hesitant to get another vaccine of this type ( previous vac astra zeneca and no reaction). no one the patient spoke to would confirm the reaction was from the vaccine. no follow-up attempts are possible. no further information is expected

Lab Data
test name: investigation nos; result unstructured data: test result:unknown results
List of symptoms
anxiety investigation palpitations
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