Détails du rapport Vaer
Âge: N/A
Genre: Female
Région : Outside US
- Patient décédé?
- Non
- Renseignements sur les vaccins
-
Nom: COVID19 (COVID19 (PFIZER-BIONTECH))
Type : Coronavirus 2019 vaccine
Fabricant: PFIZER
Lot: fl9994
- Date de réception du rapport
- 2022-03-04
- Date à laquelle le formulaire est complèté
- Date de vaccination
- 2022-01-22
- Date d’apparition
- 0
- Nombre de jours (date d’apparition – date de vaccination)
- 0
- Description de l’événement indésirable
-
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
- Données de laboratoire
-
test date: 20211222; test name: covid-19 virus test; result unstructured data: test result:yes - positive covid-19 test
- Liste des symptômes
-
pruritus rash follicular skin hyperpigmentation sars-cov-2 test
- Patient décédé?
- Non
- Date de décès
- N/A
- Anomalie congénitale
- false
- Vaccin administré par :
- Other
- Vaccin acheté par :
- Inconnu
- Visite d’un patient à l’urgence?
- Non
- Patient hospitalisé?
- Non
- Séjour à l’hôpital
- Non
- Nombre de jours à l’hôpital
- Non spécifié
- Invalidité permanente?
- Non
- Allergies:
-
na
- Maladie actuelle
-
na