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VAERS Report 2157426

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: unknown


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

skin reaction of erythema multiforme type (diffuse over several body areas, with the appearance of nodules with a raised edge, persistent for several weeks); this is a spontaneous report received from a contactable reporter(s) (physician). a 16 year-old female patient received bnt162b2 (comirnaty) (batch/lot number: unknown) as dose 1, single for covid-19 immunisation. the patient's relevant medical history and concomitant medications were not reported. the following information was reported: erythema multiforme (medically significant), outcome "not recovered", described as "skin reaction of erythema multiforme type (diffuse over several body areas, with the appearance of nodules with a raised edge, persistent for several weeks)". therapeutic measures were taken as a result of erythema multiforme. clinical course included: the reaction is described as diffuse over several body areas, with the appearance of nodules with a raised edge, persistent for several weeks and still being treated with cortisone therapy without apparent improvement. although the doctor wasn't the girl's direct physician. the lot number for bnt162b2 was not provided and will be requested during follow up.; sender's comments: based on the information in the case report, a possible causal relationship between the event erythema multiforme and suspect drug bnt162b2 cannot be excluded. the impact of this report on the benefit/risk profile of the pfizer product is evaluated as part of pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, ethics committees, and investigators, as appropriate

Lab Data
na
List of symptoms
erythema multiforme
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