Received May 21, 2026
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| COVID19 | COVID19 (COVID19 (PFIZER-BIONTECH)) | PFIZER\BIONTECH | 1 | ER2613 | — |
I have no idea when doctor's visits were; I have lost mental capacity; I have not slept in three to five years; I am not able to concentrate to fill out any form; This is a spontaneous report received from a Consumer or other non HCP. A patient (age and gender not provided) received BNT162b2 (COMIRNATY), in 2021 as dose 1, single (Lot number: ER2613) for covid-19 immunisation. The patient's relevant medical history and concomitant medications were not reported. The following information was reported: DISTURBANCE IN ATTENTION (non-serious) with onset 2021, outcome "not recovered", described as "I am not able to concentrate to fill out any form"; MENTAL IMPAIRMENT (medically significant) with onset 2021, outcome "not recovered", described as "I have lost mental capacity"; INSOMNIA (non-serious) with onset 2021, outcome "not recovered", described as "I have not slept in three to five years"; MEMORY IMPAIRMENT (non-serious), outcome "unknown", described as "I have no idea when doctor's visits were". Clinical course: Consumer stated, Lot: ER2613. That is the number that is under the Pfizer. It is on patient vaccination card. Consumer was informed it is fine if they do not have the information, they can mention the same on the letter that they are not able to fill the letter out and send it back to the sender's address and same will be mentioned in the report. Consumer stated, wonder if u can find in patient record a complaint for a side effect that started 5 years ago. Patient have vaccination record card and patient received a packet from Pfizer to fill out, but patient no longer able to fill out forms. Consumer stated, The first COVID vaccine. patient only got the first shot. (Manufacturer clarified as Pfizer).Consumer stated, received a form, but have been unable to fill out forms for 3 years, because patient have not slept in three to five years since the day patient took the shot. Consumer was informed same will be mentioned in the report and requested to mention the same on the letter that they are not able to fill the letter out and send it back to the senders address. Consumer further stated, need assistance from a nurse or doctor to fill out the form. patient have lost mental capacity in the last five years, because patient have had not sleep for 5 years. patient was confined to home. Patient was not able to drive and patient was not able to concentrate to fill out any form. Consumer stated, patient was able to fill out simple forms, but not able to fill out medical forms. The packet that Pfizer sent was 20 pages long and patient was supposed to try to remember 20 doctors visits and patient have no idea when doctors visits were.