Age: 76.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Anticoagulant therapy, Atrial flutter, Atrioventricular block, Electrocardiogram abnormal
Clinical narrative: This is a spontaneous report received from contactable reporter(s) (Consumer or other non HCP), Program ID: Unknown. The reporter is the patient. A 76-year-old male patient received BNT162b2 (BNT162B2), on 07Apr2022 at 15:00 as dose 4 (booster), 0.3 ml single (Lot number: FP4554, Expiration Date: Apr2023) at the age of 76 years, in left deltoid for Covid-19 immunisation. The patient's relevant medical history included: "Triple Bypass", start date: 04Oct2014 (unspecified if ongoing), notes: Triple Bypass He was on a ventilator relative to this; "Covid", start date: Jan2021 (unspecified if ongoing), notes: COVID Before the first shot he had COVID; "blood pressure" (unspecified if ongoing), notes: It has been consistent for the last 3 years. Takes blood pressure medication Furosemide. The patient's family history included: "his mother died at 45 from cancer, father had cancer. He has been married 53 years." (unspecified if ongoing). Concomitant medication(s) included: FUROSEMIDE taken for blood pressure abnormal. Vaccination history included: BNT162b2 (Dose:1, Lot No: EN6202, Dose: Injection to left deltoid at 09:00, Time of Onset: (24-hour clock): 01:00), administration date: 26Feb2021, when the patient was 74-year-old, for Covid-19 Immunization, reaction(s): "Nausea", "Chills"; BNT162b2 (Dose:2, Lot No: EN6207, Dose: Injection to left deltoid at 09:00), administration date: 19Mar2021, when the patient was 74-year-old, for Covid-19 Immunization; BNT162b2 (Dose:3, Lot No: 301258A, Dose: Injection to left deltoid at 09:00), administration date: 30Sep2021, when the patient was 75-year-old, for Covid-19 Immunization; Gamma globulin (Manufacturer/Lot/NDC/Expiry: Unknown), administration date: 1968, for immunisation, reaction(s): "Quite a reaction"; Cholera (Vaccination Date: Unknown other than years ago., Manufacturer/Lot/NDC/Expiry: Unknown, Adverse Event: Reaction), for immunisation, reaction(s): "Adverse Event: Reaction"; Yellow fever (Vaccination Date: Unknown other than years ago., Manufacturer/Lot/NDC/Expiry: Unknown), for immunisation; Prevnar, for Pneumonia; Shingles shots (He had shingles shots in the past, nothing recent, Other reactions just like a little headache), for immunisation, reaction(s): "little headache" Vaccination history included: BNT162b2 (Dose:1, Lot No: EN6202, Dose: Injection to left deltoid at 09:00, Time of Onset: (24-hour clock): 01:00), administration date: 26Feb2021, when the patient was 74-year-old, for Covid-19 Immunization, reaction(s): "Nausea", "Chills"; BNT162b2 (Dose:2, Lot No: EN6207, Dose: Injection to left deltoid at 09:00), administration date: 19Mar2021, when the patient was 74-year-old, for Covid-19 Immunization; BNT162b2 (Other reactions just like a little headache. Patient Knees buckled. It was a needle like a racehorse that they gave him in the small of his back. In the Army they give you an air gun basically with serum in a little vial; the air gun looks like what a mechanic would use to change a tire). The following information was reported: VACCINATION SITE PAIN (non-serious) with onset 07Apr2022 at 09:00, outcome "unknown", described as "the injection it burned, he had a burning sensation"; HEART RATE INCREASED (medically significant) with onset 09Apr2022, outcome "unknown", described as "elevated pulse"; RENAL IMPAIRMENT (medically significant) with onset Apr2022, outcome "unknown", described as "Blood test showed abnormal kidneys which he correlated to him usually being dehydrated"; HYPERTENSION (hospitalization, medically significant) with onset Apr2022, outcome "unknown", described as "High blood pressure"; SOMNOLENCE (non-serious) with onset Apr2022, outcome "unknown", described as "very sleepy"; ATRIAL FLUTTER (non-serious) with onset 22Apr2022, outcome "unknown", described as "Second booster/fourth dose: Atrial flutter". The patient was hospitalized for hypertension (start date: Apr2022, discharge date: Apr2022, hospitalization duration: 1 day(s)). The event "elevated pulse" required physician office visit. The event "high blood pressure" required emergency room visit. The patient underwent the following laboratory tests and procedures: Blood glucose: (unspecified date) that was a little off was his kidney function., notes: They checked his glucose, sodium, potassium but the only thing that was a little off was his kidney function; Blood potassium: (unspecified date) that was a little off was his kidney function, notes: They checked his glucose, sodium, potassium but the only thing that was a little off was his kidney function; Blood pressure measurement: (unspecified date) natural pulse is 62, notes: He takes blood pressure medication and normally his natural pulse is 62. With the blood pressure medication that he takes his pulse is about 55; Blood sodium: (unspecified date) that was a little off was his kidney function, notes: They checked his glucose, sodium, potassium but the only thing that was a little off was his kidney function; Blood test: (unspecified date) abnormal kidneys, notes: Blood test showed abnormal kidneys which he correlated to him usually being dehydrated and taking furosemide so that was a little off; Electrocardiogram: (22Apr2022) 99 bpm, notes: Result: Ventricular rate Unit: Not Provided; (22Apr2022) 245 bpm, notes: Result: Atrial rate Unit: Not Provided; (22Apr2022) 98ms, notes: Result: QRS duration. Unit: Not Provided; (22Apr2022) 332ms, notes: Result: Q-T interval: Unit: Not Provided; (22Apr2022) bazett 426ms, notes: Result: QTC calculation: Unit: Not Provided; (22Apr2022) 58 degrees, notes: Result: P Axis: Unit: Not Provided; (22Apr2022) 39 degrees, notes: Result: R Axis: Unit: Not Provided; (22Apr2022) 36 degrees, notes: Result: T Axis: Unit: Not Provided; (22Apr2022) Atrial flutter with variable A-V block;, notes: Unit: Not Provided; (22Apr2022) Anterior infarct age undetermined, notes: Unit: Not Provided; (22Apr2022) Abnormal, notes: Unit: Not Provided; Heart rate: (unspecified date) his heart rate drops to 50, notes: natural pulse is 62. With the blood pressure medication his pulse is about 55; (09Apr2022) elevated, notes: like the 80s, like 83; Lipids: (22Apr2022) Unknown results, notes: did not have those results or details; Oxygen saturation: (09Apr2022) 99 %, notes: His pulse oximeter at home shows his oxygen level usually runs around 98-99% and his pulse around 55; around 09Apr2022 his oxygen level was 99%; (24Apr2022) 100 %, notes: On 24Apr2022 his oxygen level was 100%. Therapeutic measures were taken as a result of hypertension, heart rate increased, atrial flutter, renal impairment. Clinical course: He had no reaction to the second dose or the first booster dose/third shot grey cap; so he wasn't expecting anything with the second booster/fourth dose. When he was administered the injection it burned, he had a burning sensation. That seemed very strange to him because he didn't have any of that with prior doses. Some of the prior doses he didn't feel anything; so he thought this event was kind of odd. Within 1.5 hours of being administered the injection he felt more alive, alert and awake than he had in years, felt invigorated and wonderful, great sense of well being. After about 2 days, around 09Apr2022 he had elevated pulse; he did not notice this for a couple of days. He takes blood pressure medication and normally his natural pulse was 62. With the blood pressure medication that he takes his pulse was about 55. When the blood pressure medication really kicks in his heart rate drops to 50 and he gets very sleepy; but he felt none of that. His pulse oximeter at home shows his oxygen level usually runs around 98-99% and his pulse around 55; around 09Apr2022 his oxygen level was 99% and his pulse went to like the 80s, like 83. On 24Apr2022 his oxygen level was 100%. Because of the heart medication and the history of triple bypass and so on and so forth he constantly checks his oxygen level and pulse rate. He knows that if you bend down to tie your shoes your pulse will increase; but he has never had a pulse of 83 prior to this event. He had an appointment with his Cardiologist last Friday, 22Apr2022. Cardiologist gave him an EKG when patient told him about the rise in the pulse rate. The EKG showed patient has atrial flutter. It was a bit unusual when he read those younger men under 30 sometimes experience atrial flutter but very rarely for someone at patient's age. Patient is going to see the Cardiologist today, 25Apr2022 to try to get some clarification on the medications and treatment for this that the Cardiologist recommended before patient had any blood test because he has some questions about his kidney function. There is not too much of a warning for his age. It has been consistent for the last 3 years. Takes blood pressure medication Furosemide. Lipid panel was done in the office on 22Apr2022, but patient did not have those results or details to provide at time of the call. Blood test showed abnormal kidneys which he correlated to him usually being dehydrated and taking furosemide so that was a little off. Actual kidney function level unknown. The Cardiologist wanted to check the blood test because he wanted to put him on a blood thinner. They checked his glucose, sodium, potassium but the only thing that was a little off was his kidney function. He read about some cases of atrial flutter in younger males, but nothing really to speak of in older people. He also read recently the other day a study done that of flutters kind of resolved after 37 weeks, 81% resolved after almost 9 months. His Cardiologist says he doesn't care what it's from, you have it, whether it's from a vaccine or something else; Patient does not want to take any medication like a blood thinner that might conflict with the booster for the flutters; that were his main concern. Apparently it's ok with the booster. It's not common. Most people haven't taken the second booster yet, so the incidence of flutters in the older population was unknown. He does not want to do anything that will end him up on dialysis, he'd rather die of a heart attack. The problem with the VA was they're too aggressive, they go for the throat and exaggerate things. They put him the Emergency room for high blood pressure with an IV and a heart monitor and he was trapped for day and a half at the hospital which was like 9000 dollars for 36 hours of care. Fortunately his medical paid for it.