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VAERS ID: 1000433

AGE: 54| SEX: M|State: FR

Description

Anaphylactic shock; severe respiratory failure; tachycardia; bronchial spasm; dyspnoea; anxiety; tachypnea; expiratory wheezing; This is a spontaneous report from a non-contactable other healthcare professional. A 54-year-old male patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Lot Number: 3002, Expiration date: 01Apr2021), intramuscular on 14Jan2021 at single dose at left arm for covid-19 immunisation. Medical history included non-hodgkin's lymphoma, bronchial asthma (Treatment: salbutamol and ipratropium bromide). The patient's concomitant medications were not reported. The patient experienced tachycardia, bronchial spasm, dyspnea, anaphylactic shock, it started immediately after vaccination with severe respiratory failure and anxiety, tachycardia and tachypnea; expiratory wheezing on 14Jan2021. Timeframe between vaccination and starting of symptoms was 1 minute. Events were serious per hospitalization. Outcome of events was unknown. Events supposedly attributable to vaccination or immunization (ESAVI) type was serious. No follow-up attempts are possible. No further information is expected.; Sender's Comments: Based on the very close temporal association, there was a reasonable possibility that the vaccination with BNT162B2 played a contributory role in triggering the onset of the reported events. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees and Investigators, as appropriate.

Symptoms

Anaphylactic shock, Tachycardia, Anxiety, Tachypnoea, Bronchospasm, Wheezing, Dyspnoea, Respiratory failure

Vaccines

VAX DATE: 13 January 2021 | ONSET DATE: 13 January 2021 | DAYS TO ONSET: 0
Vaccine TypeManufacturerVaccine NameDoseRouteSiteLot
  • COVID19
  • PFIZERBIONTECH
  • COVID19 (COVID19 (PFIZER-BIONTECH))
  • 1
  • OT
  • LA
  • 3002

RECVDATE:
03 February 2021
CAGE_YR:
CAGE_MO:
RPT_DATE:
DIED:
DATEDIED:
L_THREAT:
ER_VISIT:
HOSPITAL:
Y
HOSPDAYS:
X_STAY:
DISABLE:
RECOVD:
U
LAB_DATA:
V_ADMINBY:
OTH
OTHER_MEDS:
CUR_ILL:
HISTORY:
Medical History/Concurrent Conditions: Bronchial asthma (Treatment: salbutamol and ipratropium bromide); Non-Hodgkin's lymphoma
PRIOR_VAX:
SPLTTYPE:
MXPFIZER INC2021069211
FORM_VERS:
2
TODAYS_DATE:
31 January 2021
BIRTH_DEFECT:
OFC_VISIT:
ER_ED_VISIT:
ALLERGIES:
V_FUNDBY:
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