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VAERS Report 2157388

Case Report Section

Vaer Report Details

Age: 54 years old

Gender: Female

State: Outside US

Patient Died?
No
Vaccine information

Name: COVID19 (COVID19 (PFIZER-BIONTECH))

Type: Coronavirus 2019 vaccine

Manufacturer: PFIZER

Lot: fe7010


Date report was received
2022-03-04
Date form completed
Date Vaccinated
2021-07-13
Date of Onset
0
Number of days (onset date – vaccination date)
0
Adverse Event Description

sensation of stiffness in the movement of the right eye,; paresthesia on the right side of the body; severe headache; instability in coordination; instability in coordination; dizziness; this is a spontaneous report received from a contactable reporter(s) (other hcp) from the regulatory authority. regulatory number: it-minisal02-844263 (ra). a 54 year-old female patient received bnt162b2 (comirnaty), intramuscular, administered in deltoid left, administration date 13jul2021 17:11 (lot number: fe7010, expiration date: 31jan2022) at the age of 54 years as dose 2, single for covid-19 immunisation. the patient's relevant medical history and concomitant medications were not reported. vaccination history included: covid-19 vaccine (dose 1, manufacturer unknown), for covid-19 immunization. the following information was reported: eye pain (medically significant) with onset 13jul2021, outcome "recovering", described as "sensation of stiffness in the movement of the right eye,"; paraesthesia (non-serious) with onset 13jul2021, outcome "recovering", described as "paresthesia on the right side of the body"; headache (non-serious) with onset 13jul2021, outcome "recovering", described as "severe headache"; vertigo (non-serious), coordination abnormal (non-serious) all with onset 13jul2021, outcome "recovering" and all described as "instability in coordination"; dizziness (non-serious) with onset 13jul2021, outcome "recovering", described as "dizziness". the events "sensation of stiffness in the movement of the right eye,", "paresthesia on the right side of the body", "severe headache" and "instability in coordination" were evaluated at the physician office visit. the patient underwent the following laboratory tests and procedures: magnetic resonance imaging: (29sep2021) unknown results; neurological examination: (24jan2022) unknown results. reporter comment: inoculation site: left deltoid. sender comment: 16feb2022 local center of pharmacovigilance: requested follow-up regarding: visit reports and diagnostic tests follow-up attempts are completed. no further information is expected.; reporter's comments: inoculation site: left deltoid

Lab Data
test date: 20210929; test name: mri with contrast medium and without; result unstructured data: test result:unknown results; test date: 20220124; test name: neurological examination; result unstructured data: test result:unknown results
List of symptoms
paraesthesia headache dizziness coordination abnormal eye pain vertigo magnetic resonance imaging neurological examination
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