Age: 41.0
Sex: F
Vaccine: COVID19
Symptoms: Blood immunoglobulin G, Malaise, SARS-CoV-2 antibody test
Clinical narrative: felt something was off because she experienced absolutely nothing, zero, no reaction, no side effects, she didn't even have the pain in her arm; This is a spontaneous report from a contactable consumer from medical information team. The reporter is the patient.  A 41 year-old female patient received bnt162b2 (BNT162B2), intramuscular, administered in arm left, administration date 20Mar2021 (Lot number: ER8727) at the age of 41 years as dose 2, single for covid-19 immunisation. Relevant medical history included: "Primary Immune deficiency", start date: 2009 (ongoing), notes: Diagnosed around 2009.; "Stiff person syndrome", start date: 2019 (ongoing), notes: Diagnosed probably around the end of 2019.; "Dysautonomia", start date: Nov2020 (ongoing), notes: Additional Information for Other Conditions: Diagnosed in Nov2020, but onset was probably much earlier-but the definite diagnosis was not made until the very invasive tests were done and diagnosed in Nov2020.; "Sjogren's syndrome", start date: 2017 (ongoing), notes: Diagnosis about 4 years ago.; "Small fiber neuropathy", start date: 2019 (ongoing), notes: Additional Information for Other Conditions: Diagnosis was approximately the same time as stiff person syndrome diagnosis around the end of 2019, onset date unknown, the symptoms started much earlier but diagnosis was not made until around end of 2019.; "Prediabetes" (ongoing); "Chronic migraine", start date: 2018 (ongoing), notes: Chronic migraine headaches started in 2018.; "Endometriosis" (ongoing), notes: Onset probably a million years ago, diagnosis was in 2016.; "encephalomyelitis", start date: 2009 (ongoing), notes: Caller reported this is the new name for Chronic Fatigue Syndrome., Serofast myalgic encephalomyelitis; "Insulin resistance" (ongoing); "High sugar" (ongoing). The patient's concomitant medications were not reported. Past drug history included: Rituxan for Chemotherapy, notes: Generally her Rituxan (rituximab) treatment is cycles of 2 intravenous doses 2 weeks apart every 4 months. First of the 2 doses for this 4 month cycle being administered on 22Feb2021; and the second dose administered on 21Apr2021. Vaccination history included: Bnt162b2 (First dose., Time: 18:00., Route of administration: Intramuscular., Anatomical location: Left arm., Lot: EN6202.), administration date: 25Feb2021, when the patient was 41 years old, for Covid-19 immunization. The following information was reported: MALAISE (non-serious) with onset 25Mar2021, outcome "not recovered", described as "felt something was off because she experienced absolutely nothing, zero, no reaction, no side effects, she didn't even have the pain in her arm". Relevant laboratory tests and procedures are available in the appropriate section.  Additional information: Caller was a 41-year-old female patient who has received both doses of the Pfizer COVID vaccine. She was looking for information on recommendations on repeating the dosing regimen because she took a Semiquant antibody test and the results showed that she had no spike protein-receptor response even after both doses. She attributed this to her taking Rituxan treatment right before her 1st dose (Lot: EN6202) and 1 month after her 2nd dose (Lot: ER8727). She mentioned that it did not work for her as she did not experience any side effects even after the 2nd dose. Her doctors recommended her to get another regimen but. according to her, the state already has her on record that she received both doses. She would like to obtain documentation from Pfizer stating her that she can receive another regimen. Caller mentioned that she did not experience side effects after her doses, that was why she was attributing that the vaccine did not work. On 25Mar2021, patient felt something was off because she experienced absolutely nothing, zero, no reaction, no side effects, she didn't even have the pain in her arm. Patient was taking Pfizer Covid-19 Vaccine because she has primary immune deficiency and several autoimmune neurological conditions. This consumer was the patient who was administered both the first and second doses of Pfizer Covid-19 Vaccine. She reported that Covid antibody testing performed after both doses of Pfizer Covid-19 Vaccine had been administered showed she had zero Covid antibodies. She called for information on if there was any guidance or recommendations regarding repeating the Pfizer Covid-19 Vaccine series; and if there was any procedure or documentation that she can obtain to facilitate getting that repeated Pfizer Covid-19 Vaccine series. Her doctors do not know how to facilitate that. She wanted to repeat the Pfizer Covid-19 Vaccine series because the Covid-19 virus could be deadly for her; she was eager to repeat the series and thinks it will work for her if she waits 2 months after her last chemo treatment. She reported that after first dose of Pfizer Covid-19 Vaccine she had mild symptoms; but after the second dose of Pfizer Covid-19 Vaccine she felt something was off because she experienced absolutely nothing, zero, no reaction, no side effects, she didn't even have the pain in her arm. She qualified early for the Pfizer Covid-19 Vaccine because of her pre-existing conditions including primary immune deficiency. She was administered the Pfizer Covid-19 Vaccine while she was in the middle of chemotherapy treatment with Rituxan (rituximab). She was advised not to use any steroids, which are the usual premedication requirements for the treatment with Rituxan (rituximab), in order for the Pfizer Covid-19 Vaccine to work. She followed that advise and skipped taking steroids and she also gave an additional month between her doses of Rituxan (rituximab) to make sure that she had enough time between the first and second doses of Pfizer Covid-19 Vaccine.  Generally, her Rituxan (rituximab) treatment was cycles of 2 intravenous doses 2 weeks apart every 4 months. She adjusted that dosing scheduling relative to the Pfizer Covid-19 Vaccine to the first of the 2 doses for this 4-month cycle being administered on 22Feb2021; and the second dose administered on 21Apr2021; with no steroids taken. Rituxan (rituximab): caller provided both names Rituxan and rituximab interchangeably, whether brand name or generic unknown, caller did not have any product or information to clarify this or provide Lots/NDCs/Expiries/Further dose details for report: products are administered in infusion center, she never sees the packaging. Unfortunately, exactly 4 weeks after the second dose of Pfizer Covid-19 Vaccine, on 21Apr2021 she was tested for the Covid antibodies and had developed zero, none. Now none of her doctors know, they all want her to try it again; they want her to wait 2 months after her last chemo treatment and do this Pfizer Covid-19 Vaccine series again; but they don't know practically how to go about it. They went to the pharmacy and the pharmacy advised her to call Pfizer. Everyone was saying that after the second dose they feel kind of unwell and have some flu-like symptoms: Lots/NDCs/Expiries/clarification of product names/further details not provided, not probed on call. She didn't even have the arm pain which she did have after the first dose of Pfizer Covid-19 Vaccine. First dose: mild symptoms: Further described as pain in her arm, which was completely normal she thinks; very mild fatigue, because she was already very fatigued, so she felt more fatigued, maybe for someone healthy would be debilitating, but for her it was just extra fatigue; and maybe some cold-like symptoms but very mild. She mentioned that her weight has fluctuated greatly by about 10lbs, maybe from 140lbs to 126lbs was the last time she weighed, and that fluctuation has occurred just within the last 2 months or so. She recovered completely from this event, had no skin reaction, nothing. Patient took dose 2 injection to left arm around 07:30-08:00. Caller clarified name of Covid antibody test as: SARS-Covid-2 Semi-Quant Total AB: with results: less than 0.4-if less than 0.8 sample does not contain detectable 2 spike protein receptor binding the main (rbg) binding. Result does not contain detectable antibody. She also reported having Immunoglobulin G panel a few weeks before 21Apr2021.  No follow-up attempts are possible. No further information is expected.