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VAERS ID: 2275421

AGE: 17| SEX: M|State: TX

Description

Severe coughing; SOB; Fever 102; malaise; weakness; This is a spontaneous report received from a non-contactable reporter(s) (Consumer or other non HCP). The reporter is the patient. A 17-year-old male patient received BNT162b2 (BNT162B2), on 06May2022 at 17:45 as dose 3 (booster), single (Lot number: FK9893) at the age of 17 years, in left arm for covid-19 immunisation. The patient's relevant medical history included: "Covid-19" (unspecified if ongoing), notes: If Covid prior vaccination: Yes. The patient's concomitant medications were not reported. Vaccination history included: Covid-19 vaccine (Dose 1, Single; Manufacturer Unknown, Batch/Lot No: EW0185), for Covid-19 Immunization; Covid-19 vaccine (Dose 2, Single; Manufacturer Unknown, Batch/Lot No: Unknown/Unable to locate or read the details, Location of injection: Arm Left), for Covid-19 immunization. The following information was reported: PYREXIA (non-serious) with onset 07May2022 at 05:00, outcome "unknown", described as "Fever 102"; DYSPNOEA (non-serious) with onset 07May2022 at 05:00, outcome "unknown", described as "SOB"; COUGH (non-serious) with onset 07May2022 at 05:00, outcome "unknown", described as "Severe coughing"; MALAISE (non-serious) with onset 07May2022 at 05:00, outcome "unknown"; ASTHENIA (non-serious) with onset 07May2022 at 05:00, outcome "unknown", described as "weakness". The events "severe coughing", "sob", "fever 102", "malaise" and "weakness" required physician office visit. Relevant laboratory tests and procedures are available in the appropriate section. Therapeutic measures were not taken as a result of cough, dyspnoea, pyrexia, malaise, asthenia. Additional information: If other vaccine in four weeks: No. If Covid prior vaccination: Yes. If Covid tested post vaccination: No. No follow-up attempts are possible. No further information is expected.

Symptoms

Asthenia, SARS-CoV-2 antibody test, Cough, Dyspnoea, Malaise, Pyrexia

Vaccines

VAX DATE: 05 May 2022 | ONSET DATE: 06 May 2022 | DAYS TO ONSET: 1
Vaccine TypeManufacturerVaccine NameDoseRouteSiteLot
  • COVID19
  • PFIZERBIONTECH
  • COVID19 (COVID19 (PFIZER-BIONTECH))
  • 3
  • LA
  • FK9893

RECVDATE:12 May 2022
CAGE_YR:
CAGE_MO:
RPT_DATE:
DIED:
DATEDIED:
L_THREAT:
ER_VISIT:
HOSPITAL:
HOSPDAYS:
X_STAY:
DISABLE:
RECOVD:U
LAB_DATA:Test Date: 20220507; Test Name: Fever; Result Unstructured Data: Test Result:Fever 102; Comments: Fever 102 at 05:00; Test Name: Covid-19; Test Result: Positive ; Comments: If Covid prior vaccination: Yes
V_ADMINBY:PHM
OTHER_MEDS:
CUR_ILL:
HISTORY:Medical History/Concurrent Conditions: COVID-19 (If Covid prior vaccination: Yes.)
PRIOR_VAX:
SPLTTYPE:USPFIZER INC202200691165
FORM_VERS:2
TODAYS_DATE:11 May 2022
BIRTH_DEFECT:
OFC_VISIT:Y
ER_ED_VISIT:
ALLERGIES:
V_FUNDBY:
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