VAERS ID: 2259519

AGE: 10| SEX: M|STATE: FR

Description

Pruritic wheals; This is a spontaneous report received from a contactable reporter(s) (Other HCP) from Regulatory Authority. Regulatory number: PH-PHFDA-300143211 (RA). A 10-year-old male patient received BNT162b2 (COMIRNATY), on 05Apr2022 as dose number unknown, single (Lot number: FN4075) at the age of 10 years intramuscular for covid-19 immunisation. The patient's relevant medical history and concomitant medications were not reported. The following information was reported: RASH PRURITIC (hospitalization) with onset 06Apr2022 at 09:00, outcome "recovering", described as "Pruritic wheals". Clinical course: pruritic wheals on upper and lower extremities, trunk, and back. No follow-up attempts are possible. No further information is expected.

Symptoms

Rash pruritic

Vaccines

VAX DATE: 04-05-2022| ONSET DATE: 04-06-2022| DAYS TO ONSET: 1
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) Unknown COVID19 PFIZER\BIONTECH FN4075 OT Unknown

RECVDATE:04-30-2022
RPT_DATE:
CAGE_YR:
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:U
HOSPITAL:Y
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:N
LAB_DATA:
V_ADMINBY:OTH
OTHER_MEDS:
CUR_ILL:
HISTORY:
PRIOR_VAX:
SPLTTYPE:PHPFIZER INC202200606052
FORM_VERS:2
TODAYS_DATE:04-29-2022
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:
V_FUNDBY:

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