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VAERS ID: 1995616

AGE: 32| SEX: M|STATE: Unk

Description

Dose received: 3; Chills; Fever of 101.9; Vomiting; Can't stay awake; This is a spontaneous report from non-contactable reporter (Consumer or other non HCP). The reporter is the patient. A 32-year-old male patient received bnt162b2 (BNT162B2), administered in left arm, administration date 22Dec2021 at 14:30 (Lot number: FE3594) at the age of 32 years as dose 3 (booster), single for COVID-19 immunisation. The patient's relevant medical history and concomitant medications were not reported. Vaccination history included: Bnt162b2 (DOSE 1, SINGLE, Lot Number: EW0162, Anatomical location: Left arm), administration date: 13Apr2021, when the patient was 31 years old, and Bnt162b2 (DOSE 2, SINGLE, Lot Number: EW0172, Anatomical location: Left arm), administration date: 04May2021, when the patient was 31 years old, for COVID-19 immunisation. The following information was reported: IMMUNISATION (non-serious) with onset 22Dec2021 at 14:30, outcome "unknown", described as "Dose received: 3"; CHILLS (non-serious) with onset an unknown date in Dec2021, outcome "recovering", described as "Chills"; PYREXIA (non-serious) with onset an unknown date in Dec2021, outcome "recovering", described as "Fever of 101.9"; VOMITING (non-serious) with onset an unknown date in Dec2021, outcome "recovering", described as "Vomiting"; SOMNOLENCE (non-serious) with onset an unknown date in Dec2021, outcome "recovering", described as "Can't stay awake". Relevant laboratory tests and procedures are available in the appropriate section. Therapeutic measures were not taken as a result of chills, pyrexia, vomiting and somnolence. Additional Information: The patient did not receive any other vaccines within four weeks prior to the COVID vaccine. Prior to the vaccination, the patient was not diagnosed with COVID-19. 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. No follow-up attempts are possible. No further information is expected.

Symptoms

Body temperature, Vomiting, Chills, Immunisation, Pyrexia, Somnolence

Vaccines

VAX DATE: 21 December 2021 | ONSET DATE: 30 November 2021 | DAYS TO ONSET:
Vaccine TypeManufacturerVaccine NameDoseRouteSiteLot
  • COVID19
  • PFIZERBIONTECH
  • COVID19 (COVID19 (PFIZER-BIONTECH))
  • 3
  • LA
  • FE3594

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: 202112; Test Name: Body temperature; Result Unstructured Data: Test Result:101.9
V_ADMINBY:
PVT
OTHER_MEDS:
CUR_ILL:
HISTORY:
PRIOR_VAX:
SPLTTYPE:
USPFIZER INC202101848421
FORM_VERS:
2
TODAYS_DATE:
26 December 2021
BIRTH_DEFECT:
OFC_VISIT:
ER_ED_VISIT:
ALLERGIES:
V_FUNDBY:
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