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