VAERS ID: 2328676

AGE: | SEX: M|STATE: FR

Description

Vaccination failure; SARS-CoV-2 infection; This is a spontaneous report received from a contactable reporter(s) (Physician) from the Regulatory Authority-WEB. Regulatory number: AT-BASGAGES-2022-076768 (RA). A 54-year-old male patient received BNT162b2 (COMIRNATY), on 08May2021 as dose 1, single (Lot number: EY7015) and on 19Jun2021 as dose 2, single (Lot number: FD4555), all intramuscular for covid-19 immunisation. The patient's relevant medical history and concomitant medications were not reported. The following information was reported: COVID-19 (medically significant) with onset 21Nov2021, outcome "unknown", described as "SARS-CoV-2 infection"; DRUG INEFFECTIVE (medically significant) with onset 21Nov2021, outcome "unknown", described as "Vaccination failure". The patient underwent the following laboratory tests and procedures: SARS-CoV-2 test: (21Nov2021) Positive, notes: Variant PCR-based: B.1.617 not differentiated Variant sequenced: n.a. n501y positive: No. No follow-up attempts are possible. No further information is expected.; Sender's Comments: Linked Report(s) : AT-PFIZER INC-202200879496 Same patient/product, different dose/event;

Symptoms

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

Vaccines

VAX DATE: 06-19-2021| ONSET DATE: 11-21-2021| DAYS TO ONSET: 155
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 2 COVID19 PFIZER\BIONTECH FD4555 OT Unknown

RECVDATE:06-23-2022
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 Date: 20211121; Test Name: COVID-19 PCR test; Test Result: Positive ; Comments: Variant PCR-based: B.1.617 not differentiated Variant sequenced: n.a. n501y positive: No
V_ADMINBY:OTH
OTHER_MEDS:
CUR_ILL:
HISTORY:
PRIOR_VAX:
SPLTTYPE:ATPFIZER INC202200858709
FORM_VERS:2
TODAYS_DATE:06-23-2022
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:
V_FUNDBY:

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