이상반응 보고
| VAERS ID | 2048411 |
|---|---|
| 성별 | 여성 |
| 나이 | |
| 주 코드 | FR |
| 제약회사 | PFIZER\BIONTECH |
| 로트 번호 | FD4555 |
| 예방접종 횟수 | 2 |
| 접종일 | 2021-06-25 |
| 발병일 | 2021-11-19 |
| 상태 | 사망 |
증상
- SARS-CoV-2 테스트(SARS-CoV-2 test)
- 코로나 바이러스 감염증 -19 : 코로나 19(COVID-19)
- 약물 효과 없음(Drug ineffective)
이환 중 질병
지병
기타 의료
이전 예방접종
알레르기
임상 검사
Test Date: 20211119; Test Name: COVID-19 PCR test; Test Result: Positive ; Comments: Variant PCR-based: no information Variant sequenced: no information n501y-positive: unknown
증상 상세
Drug ineffective; SARS-CoV-2 infection; This is a spontaneous report received from a contactable reporter(s) (Physician) from the Regulatory Authority-WEB.
Regulatory number: AT-BASGAGES-2021-075696 (RA).
A 67 year-old female patient received bnt162b2 (COMIRNATY), intramuscular, administration date 25Jun2021 (Lot number: FD4555) as dose 2, single and intramuscular, administration date 14May2021 (Lot number: FA4598) as dose 1, single for covid-19 immunisation.
The patient's relevant medical history and concomitant medications were not reported.
The following information was reported: DRUG INEFFECTIVE (death) with onset 19Nov2021, outcome "fatal", described as "Drug ineffective"; COVID-19 (death) with onset 19Nov2021, outcome "fatal", described as "SARS-CoV-2 infection".
The patient underwent the following laboratory tests and procedures: sars-cov-2 test: (19Nov2021) positive, notes: Variant PCR-based: no information Variant sequenced: no information n501y-positive: unknown.
The patient date of death was unknown.
The reported cause of death was covid-19.
No follow-up attempts are possible.
No further information is expected.
; Sender's Comments: Linked Report(s) : AT-PFIZER INC-202200038798 same patient/reporter/vaccine, different dose/events.
; Reported Cause(s) of Death: SARS-CoV-2 infection