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VAERS Report 2115805

Case Report Section

Détails du rapport Vaer

Âge: 17 ans

Genre: Female

Région : Caroline du Nord

Patient décédé?
Non
Renseignements sur les vaccins

Nom: COVID19 (COVID19 (PFIZER-BIONTECH))

Type : Coronavirus 2019 vaccine

Fabricant: PFIZER

Lot: unknown


Date de réception du rapport
2022-02-16
Date à laquelle le formulaire est complèté
Date de vaccination
2021-09-03
Date d’apparition
1
Nombre de jours (date d’apparition – date de vaccination)
1
Description de l’événement indésirable

broken out in a rash; itching that turned into a rash last night; low grade fever; this is a spontaneous report received from a contactable reporter(s) (consumer or other non hcp) from medical information team. a 17 year-old female patient received bnt162b2 (bnt162b2), administered in arm left, administration date 03sep2021 (batch/lot number: unknown) at the age of 17 years as dose 1, single for covid-19 immunisation. the patient had no relevant medical history. there were no concomitant medications. the following information was reported: rash (non-serious) with onset 05sep2021, outcome "unknown", described as "broken out in a rash"; pyrexia (non-serious) with onset 04sep2021, outcome "unknown", described as "low grade fever"; pruritus (non-serious) with onset 05sep2021, outcome "unknown", described as "itching that turned into a rash last night". relevant laboratory tests and procedures are available in the appropriate section. additional information: ndc number and upc number of the suspect were unknown. when the reason for no lot number asked, it was reported that reporter did not had patients card at the time of report. grandmother (reporter) was seeking guidance on behalf of her 17year old granddaughter (patient) who had her first dose on 03sep2021 of the pfizer covid-19 vaccine. she had broken out in a rash. it started on saturday with a low grade fever and yesterday, with itching that turned into a rash last night. the reporter was to take granddaughter to the emergency department because it was the holiday today. transferring agent stated that they already addressed that and do not provide treatment recommendation but advised to reach out to her grand daughter's pediatrician or physician and she agreed to speak with them. investigation assessment was no. no follow-up attempts are possible; information about lot/batch number cannot be obtained. no further information is expected

Données de laboratoire
test name: height; result unstructured data: test result:short; test date: 20210904; test name: fever; result unstructured data: test result:low grade
Liste des symptômes
pruritus rash pyrexia body temperature body height
Patient décédé?
Non
Date de décès
N/A
Anomalie congénitale
false
Vaccin administré par :
Unknown
Vaccin acheté par :
Inconnu
Visite d’un patient à l’urgence?
Non
Patient hospitalisé?
Non
Séjour à l’hôpital
Non
Nombre de jours à l’hôpital
Non spécifié
Invalidité permanente?
Non
Allergies:
na
Maladie actuelle
na