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This is VAERS ID 1412007

History of Changes from the VAERS Wayback Machine

First Appeared on 7/23/2021

VAERS ID: 1412007
VAERS Form:2
Age:63.0
Sex:Male
Location:Foreign
Vaccinated:2021-06-02
Onset:2021-06-03
Submitted:0000-00-00
Entered:2021-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Other      Purchased by: ??
Symptoms: Body temperature, Infection, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: none
Allergies:
Diagnostic Lab Data: Test Date: 20210603; Test Name: body temperature; Result Unstructured Data: Test Result:37.9 Centigrade; Comments: after vaccine; Test Date: 20210605; Test Name: body temperature; Result Unstructured Data: Test Result:39.9 Centigrade; Comments: after vaccine
CDC 'Split Type': JPPFIZER INC2021659333

Write-up: Medical history was none. concomitant medication was not reported. The details of the reaction was reported as follow: The patient received the BNT162B2(COMIRNATY intramuscular injection, Lot number: unknown, Expiration date: unknown) on 02Jun2021 for COVID-19 immunisation. On 03Jun2021, the patient experienced pyrexia 37.9 degree centigrade, on 05Jun2021, the patient experienced pyrexia up to 39.9 degree centigrade. From pyrexia started, it lasted for a week. At the time of got information, pyrexia dropped and there was no problem. It was considered as Infection NOS caused by CMT vaccination. Additional information: Patients have no basic disease or concomitant drug. This event was found after using the product. The outcome of events was recovering. No follow-up attempts are possible; information about lot/batch number cannot be obtained.; Sender''s Comments: Based on available information, a possible contributory role of the subject product, BNT162B2 vaccine, cannot be excluded for the reported events of infection and pyrexia. There is limited information provided in this report. This case will be reassessed once additional information is available. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer 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 Regulatory Authorities, Ethics Committees and Investigators, as appropriate.

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