이상반응 보고
| VAERS ID | 2003044 |
|---|---|
| 성별 | 남성 |
| 나이 | |
| 주 코드 | FR |
| 제약회사 | PFIZER\BIONTECH |
| 로트 번호 | FJ5782 |
| 예방접종 횟수 | 3 |
| 접종일 | 2021-10-25 |
| 발병일 | 2021-10-25 |
| 상태 | 입원 중증 사망 |
증상
- 혼란 상태(Confusional state)
- 피로(Fatigue)
- 면제(Immunisation)
- 요추 천자(Lumbar puncture)
- 죽음(Death)
- 신경계 장애(Nervous system disorder)
- 헤르페스 수막뇌염(Meningoencephalitis herpetic)
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임상 검사
Test Name: Lumbar puncture; Result Unstructured Data: Test Result:herpes virus
증상 상세
Death; Fatigue; Neurological problem; Encephalitis herpes; confusion in the days following admission to hospital; Booster; This is a spontaneous report received from a contactable reporter(s) (Physician) from the Agency Agency-WEB.
Regulatory number: BE-FAMHP-DHH-N2021-111430.
A 78 year-old male patient received bnt162b2 (COMIRNATY), administration date 25Oct2021 (Lot number: FJ5782) as dose 3 (booster), single for covid-19 immunisation.
The patient's relevant medical history and concomitant medications were not reported.
Vaccination history included: Comirnaty (Dose 2, batch lot number: ET3674), administration date: 01Apr2021, for Covid-19 immunisation; Comirnaty (Dose 1, batch lot number: ER2659), administration date: 11Mar2021, for Covid-19 immunisation.
The following information was reported: IMMUNISATION (death) with onset 25Oct2021, outcome "fatal", described as "Booster"; NERVOUS SYSTEM DISORDER (death, hospitalization, life threatening) with onset 03Nov2021, outcome "fatal", described as "Neurological problem"; MENINGOENCEPHALITIS HERPETIC (death, hospitalization, life threatening) with onset 03Nov2021, outcome "fatal", described as "Encephalitis herpes"; CONFUSIONAL STATE (death, hospitalization, life threatening) with onset 03Nov2021, outcome "fatal", described as "confusion in the days following admission to hospital"; DEATH (death, hospitalization, life threatening) with onset 13Dec2021, outcome "fatal", described as "Death"; FATIGUE (death, hospitalization, life threatening) with onset 03Nov2021, outcome "fatal", described as "Fatigue".
The patient was hospitalized for nervous system disorder, meningoencephalitis herpetic, confusional state, death, fatigue (start date: 03Nov2021).
Admission to hospital was on 03Nov2021 with diagnosis of herpes encephalitis.
The patient underwent the following laboratory tests and procedures: lumbar puncture: herpes virus.
Therapeutic measures were taken as a result of immunisation, nervous system disorder, meningoencephalitis herpetic, confusional state, death, fatigue.
The patient date of death was 13Dec2021.
The reported cause of death was nervous system disorder, meningoencephalitis herpetic, confusional state, "Death", fatigue.
It was not reported if an autopsy was performed.
; Reported Cause(s) of Death: Neurological problem; Encephalitis herpes; confusion in the days following admission to hospital; Death; Fatigue