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VAERS Report 2157386

Case Report Section

Vaer Report Details

Age: NA

Gender: Male

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
2022-01-28
Date of Onset
8
Number of days (onset date – vaccination date)
8
Adverse Event Description

guillain-barre syndrome; this is a spontaneous report received from a contactable reporter (physician) from the regulatory authority-web. regulatory number: it-minisal02-844182. a 41 year-old male patient received bnt162b2 (comirnaty), administration date 28jan2022 (lot number: unknown) as dose 3 (booster), single for covid-19 immunisation. relevant medical history included: "immunodeficiency" (unknown if ongoing); "hiv" (unspecified if ongoing). concomitant medication included: dovato. vaccination history included: covid-19 vaccine (dose 1, manufacturer unknown), for covid-19 immunisation; covid-19 vaccine (dose 2, manufacturer unknown), for covid-19 immunisation. the following information was reported: guillain-barre syndrome (life threatening) with onset 05feb2022, outcome "not recovered", described as "guillain-barre syndrome". the patient underwent the following laboratory tests and procedures: cerebro spinal fluid: (05feb2022) dissociation albumino-cytological. therapeutic measures were taken as a result of guillain-barre syndrome which included igev therapy (still in progress). clinical course details: onset of dysesthesia in the 4 limbs, subsequent motor impairment with ataxia of walking. at the test performed diagnosis of guillain-barre syndrome (dissociation albumino-cytological in cerebro spinal fluid). sender's comments: 16feb2022 local regulatory authority: asked to follow up on: vaccine lot number, medications taken by the patient due to hiv immunodeficiency. no follow-up attempts are possible; information about lot/batch number cannot be obtained. no further information is expected

Lab Data
test date: 20220205; test name: cerebro spinal fluid; result unstructured data: test result:dissociation albumino-cytological
List of symptoms
csf test guillain-barre syndrome
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