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VAERS Report 2156902

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: fl9994


Date report was received
2022-03-04
Date form completed
Date Vaccinated
2022-02-12
Date of Onset
0
Number of days (onset date – vaccination date)
0
Adverse Event Description

eczema herpeticum; rapid worsening eczema and weeping sores; rapid worsening eczema and weeping sores; this is a spontaneous report received from a contactable reporter(s) (physician) from the regulatory authority web. regulatory number: gb-mhra-webcovid-202202241730214110-75s78. a 13 year-old male patient received bnt162b2 (comirnaty), administration date 12feb2022 (lot number: fl9994) as dose 2, single for covid-19 immunisation. relevant medical history included: "infected skin ulcer" (unspecified if ongoing); "eczema" (unspecified if ongoing). the patient's concomitant medications were not reported. vaccination history included: covid-19 vaccine (dose 1; manufacturer unknown), for covid-19 immunisation. the following information was reported: eczema herpeticum (medically significant) with onset 16feb2022, outcome "not recovered", described as "eczema herpeticum"; eczema (medically significant), skin lesion (medically significant) all with onset feb2022, outcome "unknown" and all described as "rapid worsening eczema and weeping sores". clinical course: it was reported that the patient had eczema anyway, had rapid worsening and weeping sores within days of the vaccine. the patient did not have symptoms associated with covid-19 and did not have a covid-19 test. the patient was not enrolled in clinical trial. the patient had not been tested positive for covid-19 since having the vaccine. the report was not related to possible inflammation of the heart (myocarditis or pericarditis), blood clots or low platelet counts. no follow-up attempts are possible. no further information is expected

Lab Data
na
List of symptoms
eczema herpeticum eczema skin lesion
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