Received Apr 24, 2025
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| COVID19 | COVID19 (COVID19 (JANSSEN)) | JANSSEN | 1 | — | — |
| COVID19 | COVID19 (COVID19 (MODERNA)) | MODERNA | 1 | — | OT |
| COVID19 | COVID19 (COVID19 (PFIZER-BIONTECH)) | PFIZER\BIONTECH | 1 | — | — |
| COVID19 | COVID19 (COVID19 (UNKNOWN)) | UNKNOWN MANUFACTURER | 1 | — | — |
patient experienced INJURY; This is a spontaneous report received from a Consumer or other non HCP. Other Case identifier(s): MOD-2025-784929 (ModernaTX, Inc.), MOD-2025-783177 (ModernaTX, Inc.). A patient (age and gender not provided) received BNT162b2 omicron (kp.2) (COMIRNATY (2024-2025 FORMULA)), as dose 1, single (Batch/Lot number: unknown) for covid-19 immunisation; elasomeran (SPIKEVAX), as dose 1, single) intramuscular for covid-19 prophylaxis; COVID-19 vaccine nrvv ad (chadox1 ncov-19) (ASTRAZENECA COVID-19 VACCINE), as dose 1, single) for product used for unknown indication; COVID-19 vaccine nrvv ad26 (jnj 78436735) (JANSSEN COVID-19 VACCINE), as dose 1, single) for product used for unknown indication. The patient had no relevant medical history. There were no concomitant medications. The following information was reported: INJURY (medically significant), outcome "unknown", described as "patient experienced INJURY". Therapeutic measures were not taken as a result of injury. Batch/lot number is not provided, and it cannot be obtained.
Comments: List of non-encoded Patient Relevant History: Patient Other Relevant History 1: None