Age: 68.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Flushing, Hypertension, Investigation, Laboratory test
Clinical narrative: blood pressure was checked and it had skyrocketed to 204/110; blood pressure had dropped to 95/58; she was lightheaded; feel chest pressure; facial flushing and warmth; facial flushing and warmth; redness on her neck and chest; This is a spontaneous report from a contactable retired registered nurse (patient). A 68-year-old female patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) via an unspecified route of administration, administered in right deltoid on 06Mar2021 10:09 (Batch/Lot Number: EN6198) at single dose for COVID-19 immunisation. Medical history included hypertension. Concomitant medications included fexofenadine hydrochloride (ALLEGRA) taken for anaphylaxis prophylaxis; famotidine (PEPCID) taken for anaphylaxis prophylaxis; cetirizine hydrochloride (ZYRTEC) taken for anaphylaxis prophylaxis; methylprednisolone acetate (MEDROL) taken for anaphylaxis prophylaxis. The patient previously received H1N1 vaccine (Sanofi Pasteur, lot number: UP006AA, expiry date: 15Mar2011) on 27Oct2009 and experienced anaphylaxis. Patient had no other vaccines on the same day as the suspect product. The patient experienced blood pressure was checked and it had skyrocketed to 204/110 (hospitalization (from 06Mar2021 to 08Mar2021)) on 06Mar2021, felt chest pressure on 06Mar2021 10:29, facial flushing and warmth on 06Mar2021 10:29, redness on her neck and chest on 06Mar2021 10:29, she was lightheaded on 08Mar2021, blood pressure had dropped to 95/58 on 08Mar2021 21:43. Clinical course: Caller states that she received her first dose of the product on 06Mar at 10:09am. Caller states that to provide some history, in Oct2009, she had anaphylaxis from the H1N1 Vaccine and in 2017, she finally found an allergist who specialized in medication allergies. Caller states that since then, any time she takes the Flu Vaccine, she pre medicates with a combination of antihistamines and a proton pump inhibitor. Caller states that in preparation of the COVID vaccine, her allergist prescribed her a Medro Dose pack and antihistamines and a proton pump inhibitor for preparation, starting three days prior to the vaccine, in order to prevent anaphylaxis. Caller states that 20 minutes post receiving the vaccine, she started to feel chest pressure, she had facial flushing and warmth, and redness on her neck and chest. Caller states that her blood pressure was checked and it had skyrocketed to 204/110. Caller states that she did not have anaphylaxis though. Caller reports that with her blood pressure being so high, they had to call paramedics, and the caller went via ambulance to the ER at about 1130am on 06Mar2021. Caller states that she spent 6 hours in the ER, and then she was put in the hospital for the next two days. Caller reports she was admitted to the hospital for her blood pressure because the ER could not get it below 185 systolic. Caller states that all her labs were negative for everything, and they checked heart attack markers that were all negative. Caller had an EKG and a stress test and those were both negative as well. Caller had blood work done, EKG and stress test that were all normal. But caller states that it took a while to get her blood pressure down. Caller states that she was talking with her allergist and he said that if she gets the second dose of the vaccine, it would need to be in a hospital setting, with an IV already in place, and caller does not think insurance will cover all that. Caller states that she did speak with an Infectious Disease doctor, who told the caller that she needs to get the second dose of the product for COVID coverage, but how would the caller move forward with getting the second dose, following what happened to her? Caller is wondering how much protection the vaccine provides after just one dose? Caller is also wondering, the hospital gave her at least two or three doses of Solu-Medrol, and caller is wondering if having received steroids in the hospital would reduce the efficacy of the COVID vaccine, and if so, by how much? Event Details: Caller had the vaccine, and the reaction started on 06Mar2021, and she was admitted on the same day. Caller was discharged from the hospital on 08Mar2021 around 330pm. Caller reports that the morning of her discharge from the hospital, her blood pressure had gotten back to 135 systolic, but before it was time for her to go down for the stress test, it was back to 159, and down while she was in nuclear medicine, it got to 160 systolic. Caller reports that the day she was discharged, she went home and got settled in, and she took her blood pressure and it was down to 128/78, but then that evening, things got spinning around her, and lights were flickering in her head, and she was lightheaded, and her blood pressure was 110/63 at 9pm and by 9:43pm, her blood pressure had dropped to 95/58. Caller states that it has not been a fun trip. Caller reports that the next morning, her blood pressure was back up to 139/78, but then later in the day she was lightheaded again, and by 9am her blood pressure was 111/69. Caller states that since then, her systolic blood pressure has been between 110 and 126. Caller states that there is nothing else she can think of. Caller states that she felt fine the morning of getting the COVID vaccine, she was looking forward to getting it, and she got herself on the list and made sure to consult with her allergist so that she would have prophylactic medications ready to go. Caller states that she does have a history of hypertension, but her blood pressure was 128/72 the morning of getting the COVID vaccine. The outcome of the events Blood pressure high and Blood pressure dropped was recovering, of the other events was unknown. The reporter considered the event blood pressure had skyrocketed to 204/110 was related to the suspect vaccine.; Sender's Comments: Based on the temporal association and known drug safety profile, a possible contributory role of vaccination with BNT162B2 to the reported event blood pressure increased 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.