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))

        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: