VAERS ID: 2328679

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-2022-076967 (RA). A 38-year-old male patient received BNT162b2 (COMIRNATY), on 28May2021 as dose 1, single (Lot number: FC0681) and on 30Jun2021 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 20Nov2021, outcome "unknown", described as "SARS-CoV-2 infection"; VACCINATION FAILURE (medically significant) with onset 20Nov2021, outcome "unknown". The patient underwent the following laboratory tests and procedures: SARS-CoV-2 test: (20Nov2021) Positive, notes: Variant PCR-based: B.1.617.2 Variant sequenced: n.a. n501y-positive: no. No follow-up attempts are possible. No further information is expected.

Symptoms

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

Vaccines

VAX DATE: 06-30-2021| ONSET DATE: 11-20-2021| DAYS TO ONSET: 143
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: 20211120; Test Name: COVID-19 PCR test; Test Result: Positive ; Comments: Variant PCR-based: B.1.617.2 Variant sequenced: n.a. n501y-positive: no
V_ADMINBY:OTH
OTHER_MEDS:
CUR_ILL:
HISTORY:
PRIOR_VAX:
SPLTTYPE:ATPFIZER INC202200858299
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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