Adverse Event Reporting
| VAERS ID | 1463306 |
|---|---|
| Gender | Unknown |
| Age | 14 |
| StateCode | CA |
| Pharmaceutical Company | PFIZER\BIONTECH |
| Lot Number | EW0186 |
| Number of vaccinations | 2 |
| Vaccinated | 2021-06-03 |
| Onset | 2021-06-04 |
| Condition | Permanent Disability Recovered |
Symptoms
- Pyrexia
- Headache
- Lethargy
- Body temperature
Current Illness
Anaphylactic reaction to food (Peritinent Details : removed tonsil, Adenoids at age 8 . carries an epinephrine injector always.); Food allergy (Peritinent Details : Uses anti histamines 6 months per year); Rhinitis
Preexisting Conditions
Medical History/Concurrent Conditions: Adenoidectomy (Removed tonsil, Adenoids at age 8 . carries an epinephrine injector always.); Fruit allergy; Pollen allergy; Tonsillectomy (Removed tonsil, Adenoids at age 8 . carries an epinephrine injector always.)
Other Medications
ZYRTEC [CETIRIZINE HYDROCHLORIDE]
Previous Vaccinations
Allergies
Laboratory Data
Test Name: Body; Result Unstructured Data: Test Result:101.
4 Fahrenheit; Test Name: Body; Result Unstructured Data: Test Result:101.
5 Fahrenheit
Write-up
Headache; fever 101.
5; fever of 101.
4 for 2 day; lethargy; This is a spontaneous report from a contactable consumer (patient).
This consumer reported similar events for two doses.
This is the first of two reports regarding dose 2.
A 14 -year-old patient of unspecified gender received the second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number EW0186) via intramuscular in left upper arm on 03Jun2021 at 11:15 AM, at patient age of 14-year-old, as a single dose for COVID-19 immunisation.
The patient medical history included ongoing oral food allergy (anti histamines 6 months per year), ongoing tree nut anaphylaxis (removed tonsil, Adenoids at age 8.
carries an epinephrine injector always).
The family medical history included Food allergy to Tree Nut: cashew/pistachio; Pollen allergy- ongoing rhinitis.
The patient concomitant medications included ongoing oral antihistamine cetirizine hydrochloride (ZYRTEC) from March (unspecified year) for allergy to pollen.
The patient previously received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number ER8735) via intramuscular in left upper arm on 13May2021 at 11:30 AM, at patient age of 14 -year-old as a single dose for COVID-19 immunisation and experienced headache.
The patient had none prior vaccinations within 4 weeks.
On 04Jun2021, the patient experienced headache with seriousness criteria: persistent/significant disability/incapacity.
The patient had 3 days fever 101.
5.
The event required to visit physicial office call.
The patient received Ibuprophen for treatment.
The patient experienced fever of 101.
4 for 2 day and lethargy after the second vaccine.
The outcome of the events was resolved.
Follow-up attempts are completed.
No further information is expected.
; Sender's Comments: Linked Report(s) : US-PFIZER INC-2021579117 same reporter/patient, different dose/event