Page breadcrumb nav

VAERS Report 2157399

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: fc5089


Date report was received
2022-03-04
Date form completed
Date Vaccinated
2021-06-18
Date of Onset
2
Number of days (onset date – vaccination date)
2
Adverse Event Description

pruritus; widespread maculo-papular rash; this is a non-interventional study report from the ra-web. regulatory number: it-minisal02-845111. a 47 year-old female patient received bnt162b2 (comirnaty), intramuscular, administration date 18jun2021 10:08 (lot number: fc5089, expiration date: 21oct2021) as dose 1, 0.3 ml single for covid-19 immunisation. relevant medical history included: "house dust mite allergy" (unknown if ongoing); "allergy to grains" (unknown if ongoing). the patient's concomitant medications were not reported. the following information was reported: pruritus (hospitalization) with onset 20jun2021, outcome "recovering", described as "pruritus"; rash maculo-papular (hospitalization) with onset 20jun2021, outcome "recovering", described as "widespread maculo-papular rash". therapeutic measures were taken as a result of pruritus, rash maculo-papular included administration of trimeton 1 fl im and urbason 40 mg 1 fl iv with partial benefit. the reporter's assessment of the causal relationship of the "pruritus" and "widespread maculo-papular rash" with the suspect product(s) bnt162b2 was not provided at the time of this report. since no determination has been received, the case is managed based on the company causality assessment. no follow-up attempts are possible. no further information is expected.; sender's comments: reported events are assessed as related to the suspect drug based on drug safety profile

Lab Data
na
List of symptoms
pruritus rash maculo-papular
Patient Died?
No
Date Died
NA
Birth defect
false
Vaccine Administered By:
Other
Vaccine Purchased By:
Unknown
Patient visit ER?
No
Patient Hospitalized?
Yes
Stay in hospital
No
Days in hospital
Unspecified
Permanent disability?
No
Allergies:
na
Current Illness
na