Report #2894557

Overview

Sex

Male

Age

Age unknown

State

OH

Recovered

Unknown

Vaccinated

—

Onset

—

Days to onset

—

Hospital days

—

Symptoms (1)

Symptom narrative

he had a violent reaction; This spontaneous report was received from a pharmacist via company representative, regarding to himself, a male patient of unknown age. The patient's medical history was not reported. The patient's past medications were not reported. The patient's concomitant medications were not reported. On an unknown date, patient was vaccinated with Pneumococcal 21-valent Conjugate Vaccine (CAPVAXIVE), (dose, frequency, route of administration, Batch/Lot Number, and expiration date were not provided) as prophylaxis. On an unknown date, he had a violent reaction (Ill-defined disorder). Also, the reporter stated that he was not interested. At the time of reporting, the outcome of ill-defined disorder was not provided. The causal relationship between ill-defined disorder and Pneumococcal 21-valent Conjugate Vaccine (CAPVAXIVE) was not reported. Lot # is being requested and will be submitted if received.