Adverse Event Reporting

VAERS ID 2594303
Gender Male
Age 37
Pharmaceutical Company PFIZER\BIONTECH
Lot Number GJ3275
Number of vaccinations 4
Vaccinated 2022-10-16
Onset 2021-12-04

Current Illness

Preexisting Conditions

Other Medications

Previous Vaccinations


Laboratory Data


COVID-19; COVID-19; Vaccine brand other=Moderna/ vaccine brand=Pfizer / BioNTech; This is a spontaneous report received from a non-contactable reporter(s) (Consumer or other non HCP) from product quality group.
The reporter is the patient.
A 38-year-old male patient received BNT162b2, BNT162b2 omi ba.
4-5 (BNT162B2, BNT162B2 OMI BA.
4-5), on 16Oct2022 as dose 4 (booster), single (Lot number: GJ3275) at the age of 37 years for covid-19 immunisation; BNT162b2 (BNT162B2), on 13Mar2021 as dose 1, single (Lot number: EN6208) and on 02Apr2021 as dose 2, single (Lot number: EW0151) for covid-19 immunisation; elasomeran (MODERNA COVID-19 VACCINE), on 04Dec2021 as dose 3 (booster), single (Lot number: 024C21A) for covid-19 immunisation.
The patient's relevant medical history and concomitant medications were not reported.
The following information was reported: INTERCHANGE OF VACCINE PRODUCTS (medically significant) with onset 04Dec2021, outcome "unknown", described as "Vaccine brand other=Moderna/ vaccine brand=Pfizer / BioNTech"; VACCINATION FAILURE (medically significant), COVID-19 (medically significant) all with onset Feb2023, outcome "unknown" and all described as "COVID-19".
Therapeutic measures were taken as a result of vaccination failure, covid-19 which included COVID-19 Treatment form 24Feb2023 to 01Mar2023.
No follow-up attempts are possible.
No further information is expected.