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VAERS Report 2156999

Case Report Section

Vaer Report Details

Age: NA

Gender: Female

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
2022-01-22
Date of Onset
0
Number of days (onset date – vaccination date)
0
Adverse Event Description

hyperpigmentation; itchy; follicular type rash on both upper arms/ lesions occurred in follicular; this is a spontaneous report received from a contactable reporter(s) (physician) from the regulatory agency (ra). a 29 year-old female patient (not pregnant) received bnt162b2 (comirnaty), administered in arm left, administration date 22jan2022 (lot number: fl9994) as dose 3 (booster), single for covid-19 immunisation. relevant medical history included: "suspected covid-19", start date: 18dec2021 (unspecified if ongoing), notes: unsure when symptoms stopped. there were no concomitant medications. vaccination history included: bnt162b2 (dose 1, lot number: ee8493), administration date: 11jan2021, for covid-19 immunisation, reaction(s): "itchy", "rash papular/follicular type rash", "covid-19 virus positive test/suspected covid-19", "covid-19 virus positive test/suspected covid-19"; bnt162b2 (dose 2, lot number: er7934), administration date: 13apr2021, for covid-19 immunisation, reaction(s): "itchy", "rash papular/follicular type rash", "patient received vaccine dose 1 on 11jan2021, dose 2 on 13apr2021", "covid-19 virus positive test/suspected covid-19", "covid-19 virus positive test/suspected covid-19". the following information was reported: skin hyperpigmentation (medically significant), outcome "not recovered", described as "hyperpigmentation"; pruritus (medically significant), outcome "not recovered", described as "itchy"; rash follicular (medically significant), outcome "unknown", described as "follicular type rash on both upper arms/ lesions occurred in follicular". the patient underwent the following laboratory tests and procedures: sars-cov-2 test: (22dec2021) yes - positive covid-19 test. works as a healthcare worker. patient was not pregnant. patient was not currently breastfeeding. patient had follicular type rash on both upper arms which she reports occured approximately 1 week after each covid vaccination on both arms. reported it being extremely itchy and occurring despite changing arms for administration. record stated vaccination only given in left arm. no further itch but has hyperpigmentation from where lesions occurred in follicular/ papular type appearance. also reports sister had same response. patient was not enrolled in clinical trial. no follow-up attempts are possible. no further information is expected.; sender's comments: linked report(s) : gb-pfizer inc-202200315021 same patient, same product, different dose and different event (loe).;gb-pfizer inc-202200315019 same patient, same product, different dose and different event.;gb-pfizer inc-202200290070 same patient, same product, different dose and different event

Lab Data
test date: 20211222; test name: covid-19 virus test; result unstructured data: test result:yes - positive covid-19 test
List of symptoms
pruritus rash follicular skin hyperpigmentation 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