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VAERS ID: 2265764

AGE: 61| SEX: F|State: NC

Description

COVID 19 Treatment; COVID 19 Treatment; This is a spontaneous report received from a contactable reporter(s) (Consumer or other non HCP). The reporter is the patient. A 61-year-old female patient received BNT162b2 (BNT162B2), on 22Mar2021 as dose 1, single (Batch/Lot number: unknown), in left arm, on 19Apr2021 as dose 2, single (Batch/Lot number: unknown), in left arm and on 30Sep2021 as dose 3 (booster), single (Batch/Lot number: unknown) at the age of 61 years, in left arm for covid-19 immunisation. The patient's relevant medical history included: "Chronic bronchitis in the past" (unspecified if ongoing), notes: Chronic bronchitis in the past. Concomitant medication(s) included: TYLENOL; ZINC; AIRBORNE. The following information was reported: DRUG INEFFECTIVE (medically significant), COVID-19 (medically significant), outcome "unknown" and all described as "COVID 19 Treatment". Therapeutic measures were taken as a result of covid-19. Reporter assessed events as non serious. The patient did not have any known allergies. The information on the batch/lot number for BNT162b2 has been requested and will be submitted if and when received.

Symptoms

COVID-19, Drug ineffective

Vaccines

VAX DATE: 29 September 2021 | ONSET DATE: | DAYS TO ONSET:
Vaccine TypeManufacturerVaccine NameDoseRouteSiteLot
  • COVID19
  • PFIZERBIONTECH
  • COVID19 (COVID19 (PFIZER-BIONTECH))
  • 3
  • LA

RECVDATE:05 May 2022
CAGE_YR:
CAGE_MO:
RPT_DATE:
DIED:
DATEDIED:
L_THREAT:
ER_VISIT:
HOSPITAL:
HOSPDAYS:
X_STAY:
DISABLE:
RECOVD:U
LAB_DATA:
V_ADMINBY:UNK
OTHER_MEDS:TYLENOL; ZINC; AIRBORNE
CUR_ILL:
HISTORY:Medical History/Concurrent Conditions: Bronchitis (Chronic bronchitis in the past)
PRIOR_VAX:
SPLTTYPE:USPFIZER INC202200658902
FORM_VERS:2
TODAYS_DATE:04 May 2022
BIRTH_DEFECT:
OFC_VISIT:
ER_ED_VISIT:
ALLERGIES:
V_FUNDBY:
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