Age: 78.0
Sex: M
Vaccine: COVID19
Symptoms: Fatigue, Mobility decreased, Myalgia, Neuralgia, Pain in extremity
Clinical narrative: extreme tiredness; arm swelling at the injection site; soreness was immediate at the injection site; arm soreness/arm was extremely painful; does not have full motion of right arm; slathering nerve/muscle pain; slathering nerve/muscle pain; This is a spontaneous report from a contactable consumer (patient).  A 78-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; solution for injection; Lot Number: Not reported), via an unspecified route of administration on 01Feb2021 (at the age of 78-year-old) as DOSE 2, SINGLE for COVID-19 immunization. The patient medical history included all kinds of injuries over the years, including military and martial arts. The patient concomitant medications were not reported. The patient previously took first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; solution for injection; Lot Number: Not reported), via an unspecified route of administration on an unspecified date in Jan2021 for COVID-19 immunization and he felt tired. The patient experienced arm swelling at the injection site and soreness was immediate at the injection site on 01Feb2021, arm soreness/arm was extremely painful, does not have full motion of right arm, extreme tiredness and slathering nerve/muscle pain on an unspecified date in 2021. It was reported that patient has had 2 side effects after receiving his second dose: swelling at the injection site and the arm is extremely painful and uncomfortable to the point it was where it was difficult to raise it above his head. He has been putting pain patches on and putting medium and low pain medication. The caller explains he is not taking anything heavy duty, Ibuprofen Equate or Bufferin 2 to 3 times a day and pain patches he gets over the counter that he is using 1- 2 times a day but he did not see any abatement to it, the pain continued. The second side effect he had was extreme tiredness. He was pretty active individual and an athlete. He reported that he felt tired after the first dose as well, just not extreme tiredness like he is feeling now. This tiredness was enough for him to notice a difference. He was a former athlete and reports that the swelling, soreness, and tiredness had not gone away. He reported soreness was immediate at the injection site before he left the building. The pain in his arm started within the 20 hours; as the swelling increase the pain increased. The swelling went down, except for a small bump that is there, but the pain was still ongoing. He was still feeling the extreme tiredness. Patient stated that he knows his body pretty well and it hurts if he exerts weight, stress, or any sign of above average movement on his right arm. He reports that he has had all kinds of injuries over the years, including military and martial arts. He reported if he exerts pressure on the right arm, it feels like he was stripping a muscle, it feels like it was falling over on itself and goes against the nerve. The pain was very sharp, it was a slathering nerve/muscle pain. The pain woke him up at night if he moves in the wrong direction, if he repositions himself. He could not use the chair to help him up or go to the gym because it hurts. He could not use any of the gym arm apparatuses. He reports on some days, the pain is much more than persistent. Patient received medium to low pain pills, Ibuprofen (Equate) 200 mg 3 tablets at a time (600 mg) at a time, 2 to 3 times a day, pain patches 1 to 2 a day for treatment of events and had no heavy duty. The outcome of the event arm swelling at the injection site was resolving and outcome of rest events was not resolved.  No follow-up attempts are possible; information about lot/batch number cannot be obtained.