VAERS ID: 2315243

AGE: 57| SEX: F|STATE:

Description

COVID-19; COVID-19; This is a spontaneous report received from a non-contactable reporter(s) (Consumer or other non HCP). The reporter is the patient. A 57-year-old female patient (not pregnant) received BNT162b2 (BNT162B2), on 09May2022 at 12:00 as dose 4 (booster), single (Lot number: FP4554) at the age of 57 years, in left arm for covid-19 immunisation; coviD-19 vaccine (COVID-19 VACCINE), as dose 1, single (Batch/Lot number: unknown), as dose 2, single (Batch/Lot number: unknown) and as dose 3 (booster), single (Batch/Lot number: unknown) for covid-19 immunisation. The patient's relevant medical history included: "known allergies: Penicillin" (unspecified if ongoing). There were no concomitant medications. The following information was reported: DRUG INEFFECTIVE (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 covid-19. Clinical course: The patient received vaccine. The patient did not receive other medication in 2weeks. Anti-viral details: The patient received treatment with Paxlovid from 28May2022 to 01Jun2022 for treatment of COVID-19. Adverse event: paxlovid recurring symptoms on day 10 from 06Jun2022 at 12:00 AM. The patient was not recovered . No follow-up attempts are possible. No further information is expected.

Symptoms

COVID-19, Drug ineffective, SARS-CoV-2 test

Vaccines

VAX DATE: 05-09-2022| ONSET DATE: | DAYS TO ONSET:
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 4 COVID19 PFIZER\BIONTECH FP4554 Unknown LA
COVID19 (COVID19 (UNKNOWN)) 3 COVID19 Unknown 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:
CUR_ILL:
HISTORY:Medical History/Concurrent Conditions: Penicillin allergy
PRIOR_VAX:
SPLTTYPE:USPFIZER INC202200806370
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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