Adverse Event Reporting
| VAERS ID | 2516943 |
|---|---|
| Gender | Female |
| Age | 38 |
| StateCode | FR |
| Pharmaceutical Company | PFIZER\BIONTECH |
| Lot Number | GD9571 |
| Number of vaccinations | 1 |
| Vaccinated | 2022-11-18 |
| Onset | 2022-11-01 |
| Condition | Permanent Disability |
Symptoms
- Asthenia
- Malaise
- Loss of consciousness
- Oedema
- Wrong product administered
Current Illness
Preexisting Conditions
Medical History/Concurrent Conditions: Alcohol allergy; Asthma; Chronic fatigue syndrome; Contrast media allergy; Depression; Developmental disturbance; Dissociative disorder; Fibromyalgia; Isolated ACTH deficiency
Other Medications
Previous Vaccinations
Allergies
Laboratory Data
Write-up
early loss of consciousness; Weakness; Malaise; Wrong vaccine administered; Oedema; This is a spontaneous report received from a contactable reporter(s) (Consumer or other non HCP).
The reporter is the patient.
A 38-year-old female patient (not pregnant) received BNT162b2, BNT162b2 omi ba.
1 (COMIRNATY RTU FOR BA.
1), on 18Nov2022 at 16:45 as dose 1, single (Lot number: GD9571, Expiration Date: 30Apr2023) at the age of 38 years, in left arm for covid-19 immunisation.
The patient didn't receive BNT162b2 (COMIRNATY).
The patient's relevant medical history included: "Isolated ACTH deficiency" (unspecified if ongoing); "fibromyalgia" (unspecified if ongoing); "Chronic fatigue syndrome" (unspecified if ongoing); "depression" (unspecified if ongoing); "Dissociative disorder" (unspecified if ongoing); "Asthma" (unspecified if ongoing); "developmental disorder" (unspecified if ongoing); "allergic to alcohol disinfection" (unspecified if ongoing); "allergic to contrast media" (unspecified if ongoing).
There were no concomitant medications (the patient did not receive any medication within 2 weeks of vaccination).
Past drug history included: Fosmicin, reaction(s): "allergy".
The following information was reported: WRONG PRODUCT ADMINISTERED (non-serious) with onset 18Nov2022 at 16:45, outcome "unknown", described as "Wrong vaccine administered".
Clinical course was as follows: the patient experienced early loss of consciousness immediately after vaccination, on 19Nov2022.
She woke up after 4 to 5 minutes, experienced weakness and malaise.
Three days later, oedema was observed but did not improve.
The outcome of the other events was not reported.
She left medical institutions alone.
No follow-up attempts are possible.
No further information is expected.