National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1729698

Government Disclaimer on use of this data

History of Changes from the VAERS Wayback Machine

First Appeared on 9/24/2021

VAERS ID: 1729698
VAERS Form:2
Age:16.0
Sex:Male
Location:Foreign
Vaccinated:2021-09-10
Onset:2021-09-10
Submitted:0000-00-00
Entered:2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -

Administered by: Other      Purchased by: ??
Symptoms: Anaphylactic shock, Blood pressure measurement

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
Allergies:
Diagnostic Lab Data: Test Date: 20210910; Test Name: Blood pressure; Result Unstructured Data: Test Result:95/50; Comments: the day of vaccination; Test Date: 20210910; Test Name: Blood pressure; Result Unstructured Data: Test Result:120; Comments: the day of vaccination
CDC 'Split Type': JPPFIZER INC202101213211

Write-up: Anaphylactic shock; This is a spontaneous report from a contactable physician via a Pfizer sales representative. The patient was a 16-year-old male. It was unknown whether the patient had any other medical history or not. On 10Sep2021 (the day of vaccination), the patient received the first dose of BNT162B2 (COMIRNATY, Solution for injection, Lot number unknown), at the age of 16-year-old, via an unspecified route of administration for COVID-19 immunization. On 10Sep2021 (after the vaccination), the patient experienced anaphylactic shock. The clinical course was reported as follows: After 4 to 5 minutes of vaccination, the patient felt cold, sweaty and in shock. He dripped 0.3ml of BOSMIN intravenously. The blood pressure was 95/50 and then returned to 120. He rested at home after recovering and continued to recover after that. The outcome of the event was recovered on 10Sep2021 with treatment including 0.3ml of BOSMIN intravenously. The reporter classified the anaphylactic shock as serious (life-threatening). The reporter stated that the anaphylactic shock definitely related to the BNT162B2. The lot number for the vaccine BNT162B2 was not provided and will be requested during follow up.; Sender''s Comments: Based on known drug safety profile, there is reasonable possibility of causal association between the event Anaphylactic shock and BNT162B2. 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.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1729698&WAYBACKHISTORY=ON


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