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This is VAERS ID 1415919

History of Changes from the VAERS Wayback Machine

First Appeared on 7/23/2021

VAERS ID: 1415919
VAERS Form:2
Age:23.0
Sex:Male
Location:Foreign
Vaccinated:2021-06-03
Onset:2021-06-03
Submitted:0000-00-00
Entered:2021-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH V1185 / 1 - / -

Administered by: Other      Purchased by: ??
Symptoms: Eye pain, Fatigue, Headache, Injection site pain, Pain, Body temperature abnormal

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: BUSCOPAN; CODEINE; DULOXETINE; PARACETAMOL; TEGRETOL
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Depression; Irritable bowel syndrome; Nerve pain; Pain
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': GBPFIZER INC2021657535

Write-up: Body temperature; Eye pain; Tiredness; Injection site pain; Headache; General body pain; This is a spontaneous report from a contactable consumer received from the Regulatory Authority. The regulatory authority report number is GB-MHRA-WEBCOVID-202106051714220030-BMSYI. Safety Report Unique Identifier GB-MHRA-ADR 25426201. A 23-year-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), first dose at the age of 23-year-old via an unspecified route of administration on 03Jun2021 (Batch/lot number: ET888/V1185) as single dose for COVID-19 immunization. Patient has not had symptoms associated with COVID-19. Not had a COVID-19 test. Patient is not enrolled in clinical trial. Medical history included irritable bowel syndrome, pain from an unknown date and unknown if ongoing, depression, pain, Nerve pain, all from unknown date and unknown if ongoing. Concomitant medications included hyoscine butylbromide (BUSCOPAN) taken for irritable bowel syndrome, start and stop date were not reported; codeine taken for pain; duloxetine taken for depression; paracetamol taken for pain; carbamazepine (TEGRETOL) taken for neuralgia and all start and stop dates were not reported. The patient experienced headache on 03Jun2021, general body pain on 03Jun2021, body temperature on 04Jun2021, eye pain on 03Jun2021, tiredness on 03Jun2021, injection site pain on 03Jun2021 and all reported as serious due to medically significant with outcome of not recovered. Patient has not tested positive for COVID-19 since having the vaccine. The outcome of the event injection site pain was not recovered, of others was recovering. No follow-up attempts are possible. No further information is expected.

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