Adverse Event Reporting
| VAERS ID | 2558472 |
|---|---|
| Gender | Female |
| Age | |
| StateCode | FR |
| Pharmaceutical Company | PFIZER\BIONTECH |
| Lot Number | |
| Number of vaccinations | 3 |
| Vaccinated | |
| Onset | 2022-07-11 |
| Condition | Hospitalized Permanent Disability |
Symptoms
- Dyspnoea
- Insomnia
- Oxygen saturation
- Vascular pseudoaneurysm
- Vascular stenosis
Current Illness
Preexisting Conditions
Medical History/Concurrent Conditions: Diabetes; Insufficiency renal
Other Medications
Previous Vaccinations
Allergies
Laboratory Data
Test Name: O2; Result Unstructured Data: Test Result:100%
Write-up
Insomnia; Spurious aneurysm; Vascular stenosis; Dyspnea; This is a spontaneous report received from a contactable reporter(s) (Pharmacist) from the RA-WEB.
Regulatory number: FR-AFSSAPS-MP20223734.
A 74-year-old female patient received BNT162b2 (COMIRNATY), on 01Sep2021 as dose 1, single (Lot number: FC8889), on 22Sep2021 as dose 2, single (Lot number: FC1433) and as dose 3 (booster), single (Batch/Lot number: unknown), all intramuscular for covid-19 immunisation.
The patient's relevant medical history included: "Insufficiency renal" (unspecified if ongoing); "Diabetes" (unspecified if ongoing).
The patient's concomitant medications were not reported.
The following information was reported: DYSPNOEA (hospitalization, disability) with onset 11Jul2022, outcome "not recovered", described as "Dyspnea"; INSOMNIA (hospitalization, disability) with onset 11Jul2022, outcome "not recovered"; VASCULAR PSEUDOANEURYSM (hospitalization, disability) with onset 11Jul2022, outcome "not recovered", described as "Spurious aneurysm"; VASCULAR STENOSIS (hospitalization, disability) with onset 11Jul2022, outcome "not recovered".
The patient underwent the following laboratory tests and procedures: Oxygen saturation: 100%.
Clinical course: COMIRNATY, dispersion to be diluted for injection.
COVID-19 mRNA vaccine (modified nucleoside), batch No.
FC8889, administered on 01Sep2021, D1, batch No.
FC1433, administered on 22Sep2021, D2, R1 date not communicated Clinical Summary: 11Jul2022: dyspnea, insomnia, multiple vascular stenosis and thrombosed false aneurysm -> planned angioplasty Sat O2 = 100%.
Short file no further information available.
Follow-up attempts are completed.
No further information is expected.