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VAERS Report 2157369

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: fy7065


Date report was received
2022-03-04
Date form completed
Date Vaccinated
2021-05-15
Date of Onset
22
Number of days (onset date – vaccination date)
22
Adverse Event Description

dermatitis psoriasiform; this is a spontaneous report received from a contactable reporter(s) (physician) from the regulatory authority-web. regulatory number: it-minisal02-843471. a 60 year-old female patient (unknown if pregnant) received bnt162b2 (comirnaty), intramuscular, administered in arm left, administration date 15may2021 (lot number: fy7065) as dose 1, 0.3 ml single for covid-19 immunisation. the patient's relevant medical history and concomitant medications were not reported. the following information was reported: dermatitis psoriasiform (medically significant) with onset 06jun2021, outcome "not recovered", described as "dermatitis psoriasiform". the patient underwent the following laboratory tests and procedures: biopsy skin: unknown results; dermatologic examination: unknown results. no follow-up attempts are possible. no further information is expected

Lab Data
test name: biopsy skin; result unstructured data: test result:unknown results; test name: dermatologic examination; result unstructured data: test result:unknown results
List of symptoms
biopsy skin dermatologic examination dermatitis psoriasiform
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