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VAERS ID: 1995614

AGE: 25| SEX: M|State: TX

Description

100-102 F degree fever; Chills; Tinnitus; Nausea; Minor dizziness; Headache; Dose received: 3/ Dose number =3; This is a spontaneous report from a contactable reporter (consumer or other non hcp). The reporter is the patient. A 25-year-old male patient received bnt162b2 (BNT162B2), administered in left arm, administration date 21Dec2021 at 13:00 (Lot number: 331308A) at the age of 25 years as dose 3 (booster), single for COVID-19 immunisation. Relevant medical history included: "Prehypertension" (unspecified if ongoing), notes: Pre-hypertension (~127/77) and "Protein S deficiency" (unspecified if ongoing). The patient did not take any concomitant medications. Vaccination history included: Bnt162b2 (DOSE 1, 0.3 ML SINGLE, Lot Number: ER8734), administration date: 01Apr2021, when the patient was 24 years old, for COVID-19 immunisation and Bnt162b2 (DOSE 2, 0.3 ML SINGLE, Lot Number: EN6207), administration date: 22Apr2021, when the patient was 24 years old, for COVID-19 immunisation. The following information was reported: IMMUNISATION (non-serious) with onset 21Dec2021 at 13:00, outcome "unknown", described as "Dose received: 3/ Dose number =3"; PYREXIA (non-serious) with onset 22Dec2021 at 04:00, outcome "recovering", described as "100-102 F degree fever"; CHILLS (non-serious) with onset 22Dec2021 at 04:00, outcome "recovering", described as "Chills"; TINNITUS (non-serious) with onset 22Dec2021 at 04:00, outcome "recovering", described as "Tinnitus"; NAUSEA (non-serious) with onset 22Dec2021 at 04:00, outcome "recovering", described as "Nausea"; DIZZINESS (non-serious) with onset 22Dec2021 at 04:00, outcome "recovering", described as "Minor dizziness"; HEADACHE (non-serious) with onset 22Dec2021 at 04:00, outcome "recovering", described as "Headache". Relevant laboratory tests and procedures are available in the appropriate section. Therapeutic measures were not taken as a result of pyrexia, chills, tinnitus, nausea, dizziness and headache. Additional Information: The patient had no known allergies. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the COVID-19 vaccine. Since the vaccination, the patient had not been tested for COVID-19. The events did not result in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care.

Symptoms

Body temperature, Nausea, Chills, Pyrexia, Dizziness, Tinnitus, Headache, Immunisation

Vaccines

VAX DATE: 20 December 2021 | ONSET DATE: 20 December 2021 | DAYS TO ONSET: 0
Vaccine TypeManufacturerVaccine NameDoseRouteSiteLot
  • COVID19
  • PFIZERBIONTECH
  • COVID19 (COVID19 (PFIZER-BIONTECH))
  • 3
  • LA
  • 331308A

RECVDATE:
30 December 2021
CAGE_YR:
CAGE_MO:
RPT_DATE:
DIED:
DATEDIED:
L_THREAT:
ER_VISIT:
HOSPITAL:
HOSPDAYS:
X_STAY:
DISABLE:
RECOVD:
N
LAB_DATA:
Test Date: 20211222; Test Name: Body temperature; Result Unstructured Data: Test Result:100-102 F degree
V_ADMINBY:
PHM
OTHER_MEDS:
CUR_ILL:
HISTORY:
Medical History/Concurrent Conditions: Prehypertension (Pre-hypertension (~127/77)); Protein S deficiency
PRIOR_VAX:
SPLTTYPE:
USPFIZER INC202101845158
FORM_VERS:
2
TODAYS_DATE:
26 December 2021
BIRTH_DEFECT:
OFC_VISIT:
ER_ED_VISIT:
ALLERGIES:
V_FUNDBY:
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