Sex: M
Vaccine: COVID19
Symptoms: Herpes zoster reactivation, Immunology test, Investigation, Natural killer cell count, Neurological examination
Clinical narrative: Zoster Meningitis/meningitis reactivation; Zoster Meningitis/meningitis reactivation; This is a literature report.  A 12-year-old male patient received BNT162b2 (BNT162B2), as dose 1, single (Batch/Lot number: unknown) and (Batch/Lot number: unknown) for covid-19 immunisation. The patient's relevant medical history included: "papulovesicular rash with lumbar L1 dermatomal distribution" (unspecified if ongoing), notes: the rash gradually progressed to the L2 area trunk, and scalp; "severe flank" (unspecified if ongoing), notes: 1-week history; "thigh pain" (unspecified if ongoing), notes: 1-week history; "pain persisted after discharge" (unspecified if ongoing); "vesicular rash" (unspecified if ongoing); "twitching movements" (unspecified if ongoing); "headache" (unspecified if ongoing); "photophobia" (unspecified if ongoing); "varicella zoster virus" (unspecified if ongoing); "kidney stones" (unspecified if ongoing); "enteric adenitis" (unspecified if ongoing). The patient's concomitant medications were not reported. Past drug history included: Inhaled corticosteroids. Vaccination history included: Voka (2 doses 1 at age 12 months and another at 18 months, 11 years after when received first vOka dose). The following information was reported: HERPES ZOSTER MENINGITIS (medically significant), 11 days after the suspect product(s) administration, outcome "recovered", HERPES ZOSTER REACTIVATION (medically significant), outcome "recovered" and all described as "Zoster Meningitis/meningitis reactivation". The patient underwent the following laboratory tests and procedures: Blood test: were negative; B-lymphocyte count: revealed no underlying immunodeficiency; Computerised tomogram abdomen: diagnosis of kidney stones and mesenteric adenitis; Computerised tomogram pelvis: diagnosis of kidney stones and mesenteric adenitis; C-reactive protein: within reference ranges; Culture: were negative; Gram stain: were negative; Herpes simplex test: were negative; HIV test: were negative; Immunology test: no underlying immunodeficiency; mentation: No change; Natural killer cell count: revealed no underlying immunodeficiency; Neurological examination: No change were noted; Panel-reactive antibody: greater than 30 targets detected only VZV, notes: antibodies; Platelet count: within reference ranges; Polymerase chain reaction: and were determined to be the vOka strain by the, notes: Centers for Disease Control and Prevention using a VZV fluorescence resonance energy transfer PCR; and were determined to be the vOka strain by the, notes: Centers for Disease Control and Prevention using a VZV fluorescence resonance energy transfer PCR; Protein total (15-45): 96 mg/dl; Respiratory pathogen panel: was positive for only rhinovirus/enterovirus, notes: presumably representing recent infection; SARS-CoV-2 antibody test: were negative; T-cell lymphoma: revealed no underlying immunodeficiency; Transaminases: within reference ranges; White blood cell count (0-5): 252, notes: cells/mm3; White blood cell count: within reference ranges; Whole-genome sequencing: established no clinically important variants.. Therapeutic measures were taken as a result of herpes zoster meningitis, herpes zoster reactivation.  No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.; Sender's Comments: Based on the currently available information the possibility of causal association between the events and the suspect drug BNT162B2  cannot be ruled out. The case will be reassessed once new information is available. 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.