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VAERS Report 2157427

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
Date of Onset
0
Number of days (onset date – vaccination date)
0
Adverse Event Description

symptomatic sars cov 2 infection in a booster subject; symptomatic sars cov 2 infection in a booster subject; this is a spontaneous report received from a contactable reporter(s) (consumer or other non hcp). the reporter is the patient. a 76 year-old male patient received bnt162b2 (comirnaty) (batch/lot number: unknown) as dose 3 (booster), single for covid-19 immunisation. relevant medical history included: "diabetes" (unspecified if ongoing), notes: in good multidrug control. the patient's concomitant medications were not reported. vaccination history included: comirnaty (dose 1, single), for covid-19 immunization; comirnaty (dose 2, single), for covid-19 immunization. the following information was reported: suspected covid-19 (medically significant), drug ineffective (medically significant), outcome "recovering" and all described as "symptomatic sars cov 2 infection in a booster subject. the lot number for bnt162b2 was not provided and will be requested during follow up. clinical course: symptoms: cold sore hoarseness, not fever, in apparent rapid resolution

Lab Data
na
List of symptoms
drug ineffective suspected covid-19
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