VAERS ID: 1714996

AGE: 15| SEX: M|STATE: WV (United States)

Description

Red itchy rash on torso, groin, inner elbows on both arm, back of knee on both legs, fingers, chin line, along neck/chin line. Large (approximate circumference of 1-1/2 size of a silver dollarraised lump with blister ring surrounding lump on front side of ankle

Open in Wayback Machine
(If this is a foreign report without a description you will be able to read the description in the Wayback Machine on Medalerts if the report became public for the first time before November 18, 2022.)

Symptoms

Rash, Rash pruritic, Blister, Rash erythematous, Limb mass

Vaccines

VAX DATE: 09-15-2021| ONSET DATE: 09-16-2021| DAYS TO ONSET: 1
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 1 COVID19 PFIZER\BIONTECH FC3183 SYR RA

RECVDATE:09-20-2021
RPT_DATE:
CAGE_YR:15
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:N
LAB_DATA:Visual exam given by urgent care 9/20/2021 at approximately 9am
V_ADMINBY:PHM
OTHER_MEDS:None
CUR_ILL:None
HISTORY:None
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:09-20-2021
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:None
V_FUNDBY:

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