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: 1f1012a
- Date report was received
- 2022-03-04
- Date form completed
- Date Vaccinated
- Date of Onset
- 0
- Number of days (onset date – vaccination date)
- 0
- Adverse Event Description
-
urticaria nos; this is a spontaneous report received from a contactable reporter(s) (other hcp) from the regulatory authority. regulatory number: it-minisal02-842927. a 55 year-old male patient received bnt162b2 (comirnaty), administered in deltoid left (lot number: 1f1012a) as dose 3 (booster), 0.3 ml single for covid-19 immunisation. the patient's relevant medical history and concomitant medications were not reported. vaccination history included: covid-19 vaccine (dose 1; manufacturer unknown), for covid-19 immunization; covid-19 vaccine (dose 2; manufacturer unknown), for covid-19 immunization. the following information was reported: urticaria (medically significant) with onset 17dec2021, outcome "not recovered", described as "urticaria nos". no follow-up attempts are possible. no further information is expected
- Lab Data
-
na
- List of symptoms
-
urticaria
- 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