Age: 65.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Pulmonary function test, SARS-CoV-2 test, Vital signs measurement, Wheezing
Clinical narrative: emphysema; wheeze from the pollen; allergies were not exacerbating but started the last few days; wheezing cough; she had a sore throat; agitation; chills; anxiety; tight, shallow, and labored breathing/troubles breathing/Difficulty breathing/ has to yawn a lot to get the air in; tight, shallow, and labored breathing/troubles breathing/Difficulty breathing/ has to yawn a lot to get the air in; tightness in her chest; felt like she was getting the flu; This is a spontaneous report from a contactable consumer (patient). A 65-year-old female patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE; lot EP7534), via an unspecified route of administration, administered in Left Arm on 23Mar2021 19:00 as single dose for COVID-19 immunisation. Medical history included ongoing laryngopharyngeal reflux diagnosed about 5 years ago, ongoing anxiety, usually happens during stressful circumstances; diagnosed about 20 years ago and she had had the sensation of labored breathing, dry mouth, and accelerated heart rate then yes for work like with public speaking; sensitive: Sulfa drugs, aesthetic filler in her face and allergic reaction Hyaluronic acid filler collagen and she doesn't smoke and drink. Family history included daughter was diagnosed with psychotic episode and diagnosed with mental illness and it was stressful getting that under control and she was sensitive to medication and surgical procedures she doesn't tolerate narcotics. Concomitant medication included clonazepam (KLONOPIN). She reported that she was prescribed .125 of clonazepam and it was a dissolvable sublingual and she doesn't use it frequently as she has read about reliance and potentially addictive and she will take a walk or watch a boring video to try to get her mind off it. The patient previously took oxycodone hydrochloride; oxycodone terephthalate; paracetamol (PERCOCET) and she was sensitive to Percocet; and darvocet and experienced sensitive to Darvocet post surgery; and codeine, and vicodin and was sensitive to both drugs, advil and causes her stomach to be upset, shingles vaccine, HPV vaccine, chicken pox vaccine and got 1 pox from that about 15 years ago when it first came out. The only post-surgical medicine pain reliever she can take was Tramadol and more often than not she doesn't have to do anything beyond Tylenol extra strength. On 24Mar2021, 04:00, the patient experienced extreme chills, and anxiety accompanied with tight, shallow, and labored breathing. She had troubled breathing due to this. She mentioned that she went to the emergency room (ER) that morning. On 27Mar2021, the patient had emphysema and agitation. On 26Mar2021, early in the morning, she had the breathing issue that she mentioned first concurrent with agitation and anxiety like at same time with the extreme chills. The sensation of agitation was all combined together, it like hit out of the blue while she was getting ready to go to sleep. She stated that at 4am it hit her with a sudden bout of extreme chills and at the same time a sense of anxiety, it felt like she hit a wall and couldn't get a full breath. She stays up late but wasn't doing anything anxiety provoking, she thought she was reading recipes. She sat to calm herself as she was not sure if it was a reaction or anxiety at the initial reaction fueling it further so she tried to sort of lower everything in her system and was concerned it could accelerate and not subside. At the hospital, they took her in an exam room and did her vitals and she was there about 2-3 hours and it was early in the morning and at that point sometime they took a chest x-ray, EKG, and blood work and at that point prior to that while she was waiting she was feeling a little better, the worst had subsided and she suggested she go and they asked her to stay since she was already checked in and to be seen. The doctor looked at the results and read the film and questioned about emphysema and she felt that was unrealistic reading as she doesn't smoke, doesn't drink and it's not in her genetic make up. The doctor told her lungs were showing a lot of air and she said maybe it was because she was gasping and they told her to take a big gulp of a breath and hold it to get the X-ray. The doctor suggested she see a pulmonologist and she didn't feel that was warranted. She contacted her general practitioner and they recommended she get the 2nd shot and had her see an allergist who also suggested she get the 2nd shot. The patient stated that she was not really overweight and doesn't drink and doesn't smoke and the allergist didn't mention but she saw in the paperwork that a side effect could be difficulty breathing. She had no swelling, body rash, dizziness or weakness. Since that episode, she periodically throughout the day, and she can't tell if it's anxiety or allergies or something but she felt labored breathing and tightness in her chest and can't get a full intake of breath. She reported that when she sleeps on her back the sensation disappears completely and when she sleeps on her side it reappears a little; 1-2 nights after, it woke her from sleep and she doesn't think she was dreaming about anxiety. She stated that she has never had anaphylactic if this should escalate what to do and she decided to go to the ER and they had her wait an additional 2 hours for a follow-up reading that was all clear, all fine, except emphysema thing which was again, she was just researching and forgot the medical term, she this it was hype aeration, too much air sucked in. Her general practitioner recommended she see an allergist for a 2nd opinion and was surprised she was up on anything and didn't mention side effect and the handout said it could be a possible side effect. She has to yawn a lotto get the air in. She does have laryngopharyngeal reflux prior and she clears her throat which is probably annoying and controls that through diet instead of taking Pepcid AC. She has had to clear her throat a lot but never had labored breathing or shortness of breath, that to get a full breath sometimes she has to yawn to get past that tightness of shallow breathing or labored breathing. On certain days she doesn't feel it and thinks it was done and she will have a spate and it happens and she thought there was something stressing and does a reality check and again it's that time of year and when she was taking her walk and walked past a certain block she started to wheeze from the pollen on an unspecified date and she called her allergist to see about getting something. She had a mask and that helped a little. Her allergies were not exacerbating on 23Mar2021 or 26Mar2021 but started the last few days and she has a wheezing cough that had an extended sort of wheeze at the end of the cough. Before her cough for LPR it was annoying throat clearing. After the vaccine, she took that walk through that one specific spot on her route she got to coughing and thinking she needs to call and get something prescribed something if anything if she gets the second shot it will address any of the side issues if they were related to allergies so don't have to contend. It was every night where she sort of feels it and she sleeps through the night so if it was tension related it subsides and can't distinguish what is emotional and physical but she was sleeping through the night and it was an indication that it was improving. She reported that when she visited her son and after she returned he told her he was unaware he had strep and didn't know it, he was asymptomatic and she had a sore throat and went to urgent care and had an exam and didn't have strep and doesn't know what it was but she was feeling better by the weekend. She was supposed to go back and everything was shutting and she didn't go. Maybe she was exposed and just had a mild thing while she was there. She was tested for Covid on 26Mar2021 and her result was negative, but they did not do an antibody test. She wanted to know if difficulty breathing was a common reaction with the vaccine, and if the side effects would be lesser after the 2nd dose since she already had a severe reaction after the 1st dose and if she should still receive the 2nd dose of the vaccine. She was concerned the 2nd shot will be more pronounced than the 1st and she doesn't want to go through that and it be more severe.  She has heard if you had that reaction you may have been exposed to Covid before and she may have been around people with Covid that had positives and she may have antibodies from an asymptomatic experience and it may do more harm than good and she should do the 2nd shot. She mentioned this to her allergist and was told if she has a similar symptoms to call and get a bronchodilator. She was onboard with that but wants to discuss it because she finds it hard to believe she was the only one that had difficulty breathing and was wondering what was the duration of this labored breathing. She was scheduled for the second dose 18Apr2021. Outcome of events sore throat was recovered on an unspecified date; and outcome of rest of events was unknown.