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VAERS ID: 2224875

AGE: 17| SEX: F|State: FR

Description

Syncope; Acute stress reaction; This is a spontaneous report received from a contactable reporter(s) (Physician) from Regulatory Authority. Regulatory number: 21-09-01585A (Regulatory Agency). A 17 year-old female patient received bnt162b2 (COMIRNATY) (Batch/Lot number: unknown) at the age of 17 years as dose number unknown, single for covid-19 immunisation. The patient's relevant medical history and concomitant medications were not reported. The following information was reported: SYNCOPE (medically significant), 5 minutes after the suspect product administration, outcome "recovered", described as "Syncope"; ACUTE STRESS DISORDER (medically significant), 5 minutes after the suspect product administration, outcome "recovered", described as "Acute stress reaction". Physician considered relatedness as Probable for Syncope; Probable for Acute stress reaction. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.

Symptoms

Acute stress disorder, Syncope

Vaccines

VAX DATE: | ONSET DATE: | DAYS TO ONSET:
Vaccine TypeManufacturerVaccine NameDoseRouteSiteLot
  • COVID19
  • PFIZERBIONTECH
  • COVID19 (COVID19 (PFIZER-BIONTECH))
  • UNK

RECVDATE:08 April 2022
CAGE_YR:
CAGE_MO:
RPT_DATE:
DIED:
DATEDIED:
L_THREAT:
ER_VISIT:
HOSPITAL:
HOSPDAYS:
X_STAY:
DISABLE:
RECOVD:Y
LAB_DATA:
V_ADMINBY:OTH
OTHER_MEDS:
CUR_ILL:
HISTORY:
PRIOR_VAX:
SPLTTYPE:MYPFIZER INC202200492714
FORM_VERS:2
TODAYS_DATE:07 April 2022
BIRTH_DEFECT:
OFC_VISIT:
ER_ED_VISIT:
ALLERGIES:
V_FUNDBY:
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