VAERS ID: 1879677

AGE: 28| SEX: M|STATE: MA (United States)

Description

Patient had a large rash begin to appear on her right thigh on April 25 2021.; This is a spontaneous report from a contactable consumer (reported for himself). A 28-year-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection, Lot number: ER8737), via an unspecified route of administration, administered in arm left on 06Apr2021 at 14:00 (at the age of 28 years old) as dose 1, single for covid-19 immunisation at Hospital. Medical history included attention deficit hyperactivity disorder, Other medical history: Adult ADHD. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Concomitant medication included lisdexamfetamine mesilate (VYVANSE) at a dose of 60 mg, daily taken for an unspecified indication, start and stop date were not reported. The patient previously took bactrum, minocycline, formaldehyde and experienced hypersensitivity. On 25Apr2021, the patient experienced had a large rash begin to appear on her right thigh. The adverse event resulted in doctor or other healthcare professional office and clinic visit. No treatment was received in response to the adverse events. The patient was not diagnosed with COVID-19 prior to vaccination. Since the vaccination, patient was not tested for COVID-19. The patient scheduled second dose on 27Apr2021. The outcome of the event was not recovered. No follow-up attempts are possible. No further information is expected.

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Symptoms

Rash

Vaccines

VAX DATE: 04-06-2021| ONSET DATE: 04-25-2021| DAYS TO ONSET: 19
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 1 COVID19 PFIZER\BIONTECH ER8737 LA

RECVDATE:11-18-2021
RPT_DATE:
CAGE_YR:
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:N
LAB_DATA:
V_ADMINBY:PVT
OTHER_MEDS:VYVANSE
CUR_ILL:
HISTORY:Medical History/Concurrent Conditions: ADHD (Other medical history: Adult ADHD)
PRIOR_VAX:
SPLTTYPE:USPFIZER INC2021487333
FORM_VERS:
TODAYS_DATE:11-17-2021
BIRTH_DEFECT:U
OFC_VISIT:Y
ER_ED_VISIT:U
ALLERGIES:
V_FUNDBY:

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