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VAERS ID: 2275433

AGE: 68| SEX: M|State: NY

Description

Treatment of COVID-19; Treatment of COVID-19; This is a spontaneous report received from contactable reporter(s) (Consumer or other non HCP). The reporter is the patient. A 68-year-old male patient received BNT162b2 (BNT162B2), on 30Mar2022 as dose 4 (booster), single (Lot number: FK9895) at the age of 68 years, in left arm for covid-19 immunisation; coviD-19 vaccine (COVID-19 VACCINE), as dose 1, single (Batch/Lot number: unknown), as dose 2, single (Batch/Lot number: unknown) and as dose 3 (booster), single (Batch/Lot number: unknown) for covid-19 immunisation. The patient's relevant medical history included: "Allergy: mollusks" (unspecified if ongoing), notes: known allergies: mollusks. Concomitant medication(s) included: ZOCOR. The following information was reported: DRUG INEFFECTIVE (medically significant), COVID-19 (medically significant) all with onset Apr2022, outcome "unknown" and all described as "Treatment of COVID-19". The patient underwent the following laboratory tests and procedures: SARS-CoV-2 test: (2022) Positive; (2022) Negative; (2022) Negative; (2022) Negative; (2022) Negative; (2022) Negative; (2022) Negative. Therapeutic measures were taken as a result of drug ineffective, covid-19.

Symptoms

COVID-19, Drug ineffective, SARS-CoV-2 test

Vaccines

VAX DATE: 29 March 2022 | ONSET DATE: 31 March 2022 | DAYS TO ONSET: 2
Vaccine TypeManufacturerVaccine NameDoseRouteSiteLot
  • COVID19
  • PFIZERBIONTECH
  • UNKNOWN MANUFACTURER
  • COVID19 (COVID19 (PFIZER-BIONTECH))
  • COVID19 (COVID19 (UNKNOWN))
  • 3
  • 4
  • LA
  • FK9895

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: 2022; Test Name: COVID-19 Antigen test; Test Result: Positive ; Test Date: 2022; Test Name: COVID-19 Antigen test; Test Result: Negative ; Test Date: 2022; Test Name: COVID-19 Antigen test; Test Result: Negative ; Test Date: 2022; Test Name: COVID-19 Antigen test; Test Result: Negative ; Test Date: 2022; Test Name: COVID-19 Antigen test; Test Result: Negative ; Test Date: 2022; Test Name: COVID-19 Antigen test; Test Result: Negative ; Test Date: 2022; Test Name: COVID-19 Antigen test; Test Result: Negative
V_ADMINBY:UNK
OTHER_MEDS:ZOCOR
CUR_ILL:
HISTORY:Medical History/Concurrent Conditions: Shellfish allergy (known allergies:mollusks)
PRIOR_VAX:
SPLTTYPE:USPFIZER INC202200696610
FORM_VERS:2
TODAYS_DATE:11 May 2022
BIRTH_DEFECT:
OFC_VISIT:
ER_ED_VISIT:
ALLERGIES:
V_FUNDBY:
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