National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

From the 9/17/2021 release of VAERS data:

This is VAERS ID 1408818



Case Details

VAERS ID: 1408818 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-06-01
Onset:2021-06-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-06-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Other       Purchased by: ?
Symptoms: SARS-CoV-2 test, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Suspected COVID-19; Comments: Patient is not enrolled in clinical trial Patient is not pregnant, Patient is not currently breastfeeding
Allergies:
Diagnostic Lab Data: Test Date: 20201222; Test Name: COVID-19 virus test; Result Unstructured Data: Test Result: Positive COVID-19 test
CDC Split Type: GBPFIZER INC2021640786

Write-up: Fainting; This is a solicited report from the RA from a contactable consumer received from the Regulatory Agency (RA). The regulatory authority report number is GB-MHRA-YCVM-202106012117352480-EJK1K, Safety Report Unique Identifier GB-MHRA-ADR 25401530. A 34-year-old female patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Batch/Lot number was not reported) via an unspecified route of administration on 01Jun2021 at the age of 34-year-old as single dose for covid-19 vaccination. Medical history included suspected covid-19 from 22Dec2020 to 03Jan2021. Patient was not enrolled in clinical trial. Patient was not pregnant. Patient was not currently breastfeeding. Patient last menstrual period was 19May2021. The patient''s concomitant medications were not reported. The patient experienced fainting on 01Jun2021. This event was reported as non-serious by RA. Additional information: This medication is only taken when a severe migraine occurs (unspecified). The patient underwent lab tests and procedures which included COVID-19 virus test: positive covid-19 test on 22Dec2020. The action taken in response to the event for bnt162b2 was not applicable. The outcome of event was recovered on 01Jun2021. The reporter''s assessment of the causal relationship of the event with the suspect product was not provided at the time of this report. Since no determination has been received, the case is managed based on the company causality assessment. No follow-up attempts are possible; information about lot/batch number cannot be obtained. Sender''s Comments: A causal association between BNT162B2 and the reported events cannot be excluded based on temporal relationship. The impact of this report on the benefit/risk profile of the product is evaluated as part of procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to RAs, as appropriate.


New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1408818


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166