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VAERS Report 2156915

Case Report Section

Vaer Report Details

Age: 60 years old

Gender: Female

State: Outside US

Patient Died?
No
Vaccine information

Name: COVID19 (COVID19 (PFIZER-BIONTECH))

Type: Coronavirus 2019 vaccine

Manufacturer: PFIZER

Lot: unknown


Date report was received
2022-03-04
Date form completed
Date Vaccinated
2022-01-08
Date of Onset
0
Number of days (onset date – vaccination date)
0
Adverse Event Description

eczema/eczema patches spots; this is a spontaneous report received from a contactable reporter (consumer) from the regulatory authority. the reporter is the patient. regulatory number: gb-mhra-webcovid-202202252041559720-kigss. other case identifier(s): gb-mhra-adr 26655558. a 60 year-old female patient received bnt162b2 (comirnaty), administration date 08jan2022 (batch/lot number: unknown) at the age of 60 years as dose 3 (booster), single for covid-19 immunisation. the patient's relevant medical history and concomitant medications were not reported. patient did not have symptoms associated with covid-19. patient was not enrolled in clinical trial. past drug history included: formoterol fumarate, mometasone furoate (dulera); letrozole. vaccination history included: bnt162b2 (dose 2, single; lot number: unknown), for covid-19 immunisation; bnt162b2 (dose 1, single; lot number: unknown), for covid-19 immunisation. the following information was reported: eczema (medically significant) with onset 08jan2022, outcome "not recovered", described as " eczema/eczema patches spots". the patient's body had eczema patches spots and after a shower, her body was covered in spots - this occurred right after booster, and it still continued. the patient underwent the following laboratory tests and procedures: sars-cov-2 test: no - negative covid-19 test. patient did not test positive for covid-19 since having the vaccine. the report was not related to possible inflammation of the heart (myocarditis or pericarditis). no follow-up attempts are possible; information about lot/batch number cannot be obtained. 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
eczema sars-cov-2 test
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