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From the 11/19/2021 release of VAERS data:

This is VAERS ID 1759967

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Case Details

VAERS ID: 1759967 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-08-01
Onset:2021-09-07
   Days after vaccination:37
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 1 - / OT

Administered by: Other       Purchased by: ?
Symptoms: Body mass index, Chest pain, Dyspnoea, Platelet count, Pulmonary embolism, Ultrasound Doppler
SMQs:, Anaphylactic reaction (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: NEXPLANON
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Obesity (Body Mass Index at 30); Polycystic ovarian syndrome; Tobacco user
Allergies:
Diagnostic Lab Data: Test Name: Body Mass Index; Result Unstructured Data: Test Result:30; Test Date: 202109; Test Name: platelets; Result Unstructured Data: Test Result:239 g/l; Test Date: 202109; Test Name: Lower limb Doppler; Test Result: Negative
CDC Split Type: FRPFIZER INC202101239487

Write-up: chest pain; Embolism pulmonary; dyspnea; This is a spontaneous report from a contactable physician downloaded from the Regulatory Authority-WEB, regulatory authority number FR-AFSSAPS-LY202111207. A 28-year-old female patient received 1st single dose of bnt162b2 (COMIRNATY) intramuscularly on 02Sep2021 (Batch/Lot Number: Unknown) for COVID-19 immunisation; etonogestrel (NEXPLANON) via an unspecified route of administration from Aug2021 (Batch/Lot Number: Unknown) to an unspecified date, at unspecified dose for contraception (contraceptive method not known before placement of implant). Medical history included obesity (Body Mass Index at 30) from an unknown date and unknown if ongoing, polycystic ovarian syndrome from an unknown date and unknown if ongoing, tobacco user from an unknown date and unknown if ongoing. Patient had no family medical history of thrombosis. The patient''s concomitant medications were not reported. On 07Sep2021, there was appearance of dyspnea, which consulted the Emergency Department then discharged. On 08Sep2021, there was new consultation because worsening with chest pain, which was diagnosed of right proximal bilateral pulmonary embolism and treated with Eliquis. It was reported that the patient experienced embolism pulmonary on 07Sep2021 with outcome of recovering, dyspnea on 07Sep2021 with outcome of recovering, chest pain on 08Sep2021 with outcome of recovering. As of 08Sep2021, patient was clinically stable. The patient underwent lab tests and procedures which included body mass index: 30, platelet count: 239 g/l on Sep2021, ultrasound doppler (Lower limb): negative on Sep2021. The action taken in response to the events for etonogestrel was unknown. Therapeutic measures were taken as a result of the events. Seriousness criteria of the events was hospitalized. Evidence of recent and frequent car trips (more than 5 hours). No follow-up attempts are possible. Information about lot/batch number cannot be obtained. No further information is expected.


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