Page breadcrumb nav

VAERS Report 2157440

Case Report Section

Vaer Report Details

Age: 60 years old

Gender: Male

State: Pennsylvania

Patient Died?
No
Vaccine information

Name: COVID19 (COVID19 (PFIZER-BIONTECH))

Type: Coronavirus 2019 vaccine

Manufacturer: PFIZER

Lot: fj6369


Date report was received
2022-03-04
Date form completed
Date Vaccinated
2022-01-20
Date of Onset
17
Number of days (onset date – vaccination date)
17
Adverse Event Description

systemic: exhaustion / lethargy-mild, systemic: 20% decrease (shrinkage) of male genitalia-severe

Lab Data
na
List of symptoms
fatigue lethargy genital atrophy
Patient Died?
No
Date Died
NA
Birth defect
false
Vaccine Administered By:
Pharmacy or store
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