VAERS ID: 1822909

AGE: 15| SEX: F|STATE: FR (Unknown)

Description

Pericardial effusion; left Pleural effusion; diarrhoea; chest pain; Pleurisy; palpitations; inappetence; dyspnoea; Perimyocarditis; pyrexia; Viral infection; This is a spontaneous report from a contactable physician received from the Regulatory Agency (RA). Regulatory authority report number is v21129245. The patient was a 15-year-old female. On 02Sep2021, the patient received the first dose of BNT162B2 (COMIRNATY solution of injection, Lot number FD0349, Expiration date 31Oct2021) via an unspecified route of administration as a single dose for COVID-19 immunization. On 24Sep2021 (the day of vaccination), the patient received the second dose of bnt162b2 (COMIRNATY solution of injection, Lot number FJ7489, Expiration date 31Jan2022) via an unspecified route of administration as a single dose for COVID-19 immunization. On 26Sep2021 (2 days after the vaccination), the patient experienced pleurisy and perimyocarditis. On 28Sep2021 (4 days after the vaccination), the patient was admitted to the hospital. The course of the event was as follows: The patient was healthy ever since born. On 24Sep2021, the patient received above vaccine. From 25Sep2021, the patient experienced pyrexia. On 26Sep2021, the patient experienced pyrexia of 38.5 centigrade degrees, palpitations, inappetence, and had a consultation in fever outpatient in the hospital. There were seemingly side effects, and the patient was given pyretic for processing method. But the patient went back home and experienced dyspnoea. On 27Sep2021, the patient experienced diarrhoea and chest pain. On 28Sep2021, the patient had a consultation again. The patient experienced left pleural effusion and pericardial effusion. There was no change in electrocardiogram. The patient was hospitalized. The outcome of the event was not reported. The reporting physician classified the event as serious (hospitalized from 28Sep2021) and assessed that the causality between the event and BNT162B2 as unassessable. Other possible causes of the events such as any other diseases was viral infection in 2021. No follow-up attempts are possible. No further information is expected.

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Symptoms

Pyrexia, Dyspnoea, Diarrhoea, Palpitations, Chest pain, Myocarditis, Pleural effusion, Pericardial effusion, Decreased appetite, Viral infection, Electrocardiogram, Pleurisy, Body temperature

Vaccines

VAX DATE: 09-24-2021| ONSET DATE: 09-25-2021| DAYS TO ONSET: 1
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 2 COVID19 PFIZER\BIONTECH FJ7489

RECVDATE:10-28-2021
RPT_DATE:
CAGE_YR:
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:
HOSPITAL:Y
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:U
LAB_DATA:Test Date: 20210926; Test Name: body temperature; Result Unstructured Data: Test Result:38.5 Centigrade; Test Date: 20210928; Test Name: electrocardiogram; Result Unstructured Data: Test Result:no change
V_ADMINBY:OTH
OTHER_MEDS:
CUR_ILL:
HISTORY:
PRIOR_VAX:
SPLTTYPE:JPPFIZER INC202101362814
FORM_VERS:
TODAYS_DATE:10-27-2021
BIRTH_DEFECT:U
OFC_VISIT:Y
ER_ED_VISIT:U
ALLERGIES:
V_FUNDBY:

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