VAERS ID: 2315241

AGE: 53| SEX: F|STATE:

Description

COVID-19; COVID-19; This is a spontaneous report received from a contactable reporter(s) (Consumer or other non HCP). The reporter is the patient. A 53-year-old female patient (not pregnant) received BNT162b2 (BNT162B2), on 28Jan2021 as dose 1, single (Lot number: EL9262), in left arm, on 18Feb2021 as dose 2, single (Lot number: EN6201), in left arm, on 13Oct2021 as dose 3 (booster), single (Lot number: FE3590) and on 02Apr2022 as dose 4 (booster), single (Batch/Lot number: unknown) at the age of 53 years for covid-19 immunisation. The patient's relevant medical history included: "borderline high cholesterol" (unspecified if ongoing); "pine nuts" (unspecified if ongoing). Concomitant medication(s) included: ACYCLOVIR [ACICLOVIR]; VITAMIN B12 [CYANOCOBALAMIN]; VITAMIN D3; CALCIUM; TUMS [CALCIUM CARBONATE]; IRON FERROUS SULFATE; MELATONIN; NAPROXEN SODIUM; ALEVE. Past drug history included: Albuterol/ventolin, reaction(s): "Known Allergies: Albuterol/Ventolin"; Albuterol/ventolin, reaction(s): "Known Allergies: Albuterol/Ventolin". The following information was reported: VACCINATION FAILURE (medically significant), COVID-19 (medically significant), outcome "unknown" and all described as "COVID-19". The patient underwent the following laboratory tests and procedures: SARS-CoV-2 test: Unknown Results. Therapeutic measures were taken as a result of vaccination failure, covid-19. The information on the batch/lot number for BNT162b2 has been requested and will be submitted if and when received.

Symptoms

COVID-19, SARS-CoV-2 test, Vaccination failure

Vaccines

VAX DATE: 04-02-2022| ONSET DATE: | DAYS TO ONSET:
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 4 COVID19 PFIZER\BIONTECH Unknown Unknown

RECVDATE:06-10-2022
RPT_DATE:
CAGE_YR:
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:U
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:U
LAB_DATA:Test Name: covid-19 test; Result Unstructured Data: Test Result:Unknown Results
V_ADMINBY:
OTHER_MEDS:ACYCLOVIR [ACICLOVIR]; VITAMIN B12 [CYANOCOBALAMIN]; VITAMIN D3; CALCIUM; TUMS [CALCIUM CARBONATE]; IRON FERROUS SULFATE; MELATONIN; NAPROXEN SODIUM; ALEVE
CUR_ILL:
HISTORY:Medical History/Concurrent Conditions: Allergy to nuts; High cholesterol
PRIOR_VAX:
SPLTTYPE:USPFIZER INC202200806202
FORM_VERS:2
TODAYS_DATE:06-09-2022
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:
V_FUNDBY:

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