Page breadcrumb nav

VAERS Report 2156881

Case Report Section

Vaer Report Details

Age: NA

Gender: Male

State: Outside US

Patient Died?
No
Vaccine information

Name: COVID19 (COVID19 (PFIZER-BIONTECH))

Type: Coronavirus 2019 vaccine

Manufacturer: PFIZER

Lot: fm3092


Date report was received
2022-03-04
Date form completed
Date Vaccinated
2022-02-14
Date of Onset
0
Number of days (onset date – vaccination date)
0
Adverse Event Description

itching; primary immunisation: astrazeneca; booster: comirnaty; primary immunisation: astrazeneca; booster: comirnaty; allergic reaction; hives; burning sensation of the skin; this is a spontaneous report received from a contactable reporter(s) (consumer or other non hcp) from the medicines and healthcare products regulatory agency (uk-mhra). regulatory number: gb-mhra-webcovid-202202231139368450-jknsq (mhra). other case identifier(s): gb-mhra-adr 26639876 (mhra). a 42 year-old male patient received bnt162b2 (comirnaty), administration date 14feb2022 (lot number: fm3092) as dose 3 (booster), single for covid-19 immunisation. the patient's relevant medical history and concomitant medications were not reported. vaccination history included: covid-19 vaccine astrazeneca (dose 2), administration date: 21jun2021, for covid-19 immunisation; covid-19 vaccine astrazeneca (dose 1), administration date: 21mar2021, for covid-19 immunisation. the patient had no symptoms associated with covid-19 and was not enrolled in clinical trial. the following information was reported: off label use (medically significant), interchange of vaccine products (medically significant) all with onset 14feb2022, outcome "unknown" and all described as "primary immunisation: astrazeneca; booster: comirnaty"; hypersensitivity (medically significant) with onset feb2022, outcome "not recovered", described as "allergic reaction"; urticaria (medically significant) with onset feb2022, outcome "not recovered", described as "hives"; pruritus (medically significant) with onset 16feb2022, outcome "not recovered", described as "itching"; skin burning sensation (medically significant) with onset feb2022, outcome "unknown", described as "burning sensation of the skin". the events "allergic reaction", "hives", "itching" and "burning sensation of the skin" were evaluated at the physician office visit, doctors appointment was reported. the patient underwent the following laboratory tests and procedures: sars-cov-2 test: no - negative covid-19 test. the patient had not been tested positive for covid-19 since having the vaccine. no follow-up attempts are needed. no further information is expected

Lab Data
test name: covid-19 virus test; result unstructured data: test result:no - negative covid-19 test
List of symptoms
pruritus urticaria hypersensitivity interchange of vaccine products skin burning sensation sars-cov-2 test off label use
Patient Died?
No
Date Died
NA
Birth defect
false
Vaccine Administered By:
Other
Vaccine Purchased By:
Unknown
Patient visit ER?
No
Patient Hospitalized?
No
Stay in hospital
No
Days in hospital
Unspecified
Permanent disability?
No
Allergies:
na
Current Illness
na