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VAERS Report 2156949

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: elo739


Date report was received
2022-03-04
Date form completed
Date Vaccinated
2021-01-24
Date of Onset
250
Number of days (onset date – vaccination date)
250
Adverse Event Description

itchy skin; severe rash and random skin eruptions; regulatory authority vaccine monitor this is a solicited report received from a contactable reporter(s) (consumer or other non hcp) from the regulatory authority for a sponsored program. regulatory number: gb-mhra-ycvm-202101271028554990. other case identifier(s): gb-mhra-adr 26630081. a 83 year-old male patient received bnt162b2 (bnt162b2), administration date 24jan2021 (lot number: elo 739) as dose 3 (booster), single for covid-19 immunisation. relevant medical history included: "hypertension" (unspecified if ongoing). concomitant medication(s) included: tenoret taken for hypertension, start date: 07jul1980. vaccination history included: bnt162b2 (dose 1), for covid-19 immunisation; bnt162b2 (dose 2), for covid-19 immunisation. unsure if patient has had symptoms associated with covid-19 not had a covid-19 test. patient has not tested positive for covid-19 since having the vaccine. patient is not enrolled in clinical trial the following information was reported: pruritus (medically significant) with onset oct2021, outcome "not recovered", described as "itchy skin"; rash (medically significant) with onset oct2021, outcome "unknown", described as "severe rash and random skin eruptions". the events "itchy skin" and "severe rash and random skin eruptions" were evaluated at the physician office visit. clinical course: the patient developed the severe rash and random skin eruptions after his pfizer booster jab last october for which he was seen by his gp. he experienced severe itching notably on the trunk. for the record, he had no reactions after the first 2 jabs (also pfizers). no follow-up attempts are possible. no further information is expected.; sender's comments: based on temporal association, there is reasonable possibility of causal association between the reported events and the suspect drug bnt162b2. the impact of this report on the benefit/risk profile of the pfizer drug is evaluated as part of pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, ethics committees, and investigators, as appropriate

Lab Data
na
List of symptoms
pruritus rash
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