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VAERS Report 2157403

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: 33193tb


Date report was received
2022-03-04
Date form completed
Date Vaccinated
2022-01-21
Date of Onset
7
Number of days (onset date – vaccination date)
7
Adverse Event Description

dysentery; severe facial redness with erythema; vomiting; nausea; severe lethargy; high fatigue/exhaustion; abdominal cramps; left leg paraesthesia with severe tingling; this is a spontaneous report received from a contactable reporter(s) (consumer or other non hcp) from the agency regulatory authority-web. the reporter is the patient. regulatory number: it-minisal02-845428. a 17 year-old female patient received bnt162b2 (comirnaty), administered in arm right (right shoulder), administration date 21jan2022 (lot number: 33193tb) as dose 1, single for covid-19 immunisation. relevant medical history included: "epilepsy" (unspecified if ongoing), notes: subject under treatment between 8 and 14 years for epilepsy myoclonic absences. the patient's concomitant medications were not reported. the following information was reported: dysentery (medically significant) with onset 28jan2022, outcome "recovering", described as "dysentery"; erythema (non-serious) with onset 28jan2022, outcome "recovering", described as "severe facial redness with erythema"; vomiting (non-serious) with onset 28jan2022, outcome "recovering", described as "vomiting"; nausea (non-serious) with onset 28jan2022, outcome "recovering", described as "nausea"; lethargy (non-serious) with onset 28jan2022, outcome "recovering", described as "severe lethargy"; fatigue (non-serious) with onset 28jan2022, outcome "recovering", described as "high fatigue/exhaustion"; abdominal pain (non-serious) with onset 28jan2022, outcome "recovering", described as "abdominal cramps"; paraesthesia (non-serious) with onset 28jan2022, outcome "recovering", described as "left leg paraesthesia with severe tingling". the patient underwent the following laboratory tests and procedures: fibrin d dimer (normal high range 55): 89; quality of life decreased: 9/10. therapeutic measures were taken as a result of dysentery, erythema, vomiting, nausea, lethargy, fatigue, abdominal pain, paraesthesia which included administration of immodium, vitamin b12 and antibiotic rifacol 200mg. health authority comment: subject under treatment between 8 and 14 years for epilepsy myoclonic absences. vaccine pfizer lot 33193tb administered on 21jan2022. no follow-up attempts are possible. no further information is expected

Lab Data
test name: fibrin d dimer; result unstructured data: test result:89; test name: impact on quality of life; result unstructured data: test result:9/10
List of symptoms
paraesthesia dysentery fatigue vomiting nausea lethargy erythema abdominal pain quality of life decreased fibrin d dimer
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