VAERS ID: 2202645

AGE: 14| SEX: F|STATE: FR

Description

Headache; dizziness/when touching down, longer monitoring; Malaise; This is a spontaneous report received from non-contactable reporter(s) (Consumer or other non HCP and Other HCP) from the Regulatory Authority-WEB. Regulatory number: DE-PEI-202200088407. A 14-year-old female patient received bnt162b2 (COMIRNATY), intramuscular, administration date 18Jan2022 (Lot number: PCA0004) at the age of 14 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: Comirnaty (Dose 1, Batch/lot number: FE8236, Route of Administration: Intramuscular), administration date: 17Aug2021, for COVID-19 immunization; Comirnaty (Dose 2, Batch/lot number: SCKX7 , Route of Administration: Intramuscular), administration date: 21Sep2021, for COVID-19 immunization. The following information was reported: HEADACHE (hospitalization) with onset 18Jan2022, outcome "unknown", described as "Headache"; DIZZINESS (hospitalization) with onset 18Jan2022, outcome "unknown", described as "dizziness/when touching down, longer monitoring"; MALAISE (hospitalization) with onset 18Jan2022, outcome "unknown", described as "Malaise". The causality assessment for suspect drug to event Dizziness was reported as D. Unclassifiable and for the events Headache, Malaise were reported as B. Indeterminate. Source of assessment: Regulatory Authority No follow-up attempts are possible. No further information is expected.

Symptoms

Dizziness, Headache, Malaise

Vaccines

VAX DATE: 01-18-2022| ONSET DATE: 01-18-2022| DAYS TO ONSET: 0
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 3 COVID19 PFIZER\BIONTECH PCA0004 OT Unknown

RECVDATE:03-29-2022
RPT_DATE:
CAGE_YR:
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:U
HOSPITAL:Y
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:U
LAB_DATA:
V_ADMINBY:OTH
OTHER_MEDS:
CUR_ILL:
HISTORY:
PRIOR_VAX:
SPLTTYPE:DEPFIZER INC202200414755
FORM_VERS:2
TODAYS_DATE:03-27-2022
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:
V_FUNDBY:

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