Age: 72.0
Sex: F
Vaccine: COVID19
Symptoms: Blood pressure measurement, Blood test, Fatigue, Head discomfort, Palpitations
Clinical narrative: She has bumps all over her head; feel weak; felt heart beating; felt really tired; check her blood pressure and it went down to 95; her cholesterol was kind of high; her head feels like it is swelling and bleeding; her head feels like it is swelling and bleeding; Hives; itching all over her body; Skin feels tight; sometimes she would get up in the middle of the night due to the itching; Rash; This is a spontaneous report from a contactable consumer (patient herself).   A 72-year-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Batch/Lot number was not reported), via an unspecified route of administration, administered in left arm on 26Apr2021 11:45 (age at vaccination: 72 years) as DOSE 2, SINGLE for covid-19 immunisation. The patient's medical history included ongoing asthma. Concomitant medication(s) included fluticasone propionate (+) salmeterol xinafoate (ADVAIR) taken 250mg inhaler twice a day for asthma. The patient's historical vaccine included bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Lot: EP7533 Exp: 31Jul2021) administered in left arm, dose 1 for covid-19 immunisation. On 26Apr2021, the patient's head feels like it is swelling and bleeding especially when she scratches, hives, itching all over her body; On an unknown date in 2021, the patient had rashes, On an unknown date in April2021, the patient's skin feels tight, sometimes she would get up in the middle of the night due to the itching, scratching; On an unknown date, the patient had bumps all over her head, but she cannot really see them because of hair; On an unknown date in June2021, the patient's cholesterol was kind of high. The patient did not require a visit to emergency room but required a physician's office visit. The event of hives and rash were reported to be worsened. She reported that it was like from head to toe and her head feels like it was swelling and bleeding. All around her body she has rash, itching, hives, and now it goes down to her thighs, front and back of legs. She has seen her allergy doctor who tried to treat her with steroids first. The reporter stared that she has seen the allergy doctor and skin doctor and it's like no one can help her. The hives started right away from the moment she got the shot. She got bumps that goes all the way around the location of where she got the shot. At first, they were on her left arm and now they're around her back, left arm, shoulder. It's gone to her right arm. It's on both shoulders, shoulder blades. She has itching and it goes all the way down her back. The hives are now around her belly. She stated she is scratching right now. She was scratching so bad sometimes she was bleeding. The itching started right away. The last couple of days she could not stand it. At first, she saw withheld, the allergy doctor and was informed it was a Covid vaccine reaction she was having. She was prescribed Prednisone two different times, 40mg a day for seven days after that 10mg a day, but it did not work. After this did not work, she went back to the doctor who gave another Prednisone dose, it was a low dose 5mg, two tablets a day by mouth for seven days and one a day for 14 days. She was given Clobetasol- 5mg ointment, Ivermectin- 12 tablets, told to take one day 6 tablets, wait for week and take another 6 tablets in one day. Second time took the last six tablets and started to feel weak. Sometimes she felt heart beating and it stopped. About 2 hours later she felt really tired. She went to check her blood pressure and it went down to 95 and that time. She was also given a cream to put all over body from head to toes for the rash, Triamcinolone 1% cream 464gm (Expiration date: April2023). This did not work. withheld said since all the other medication did not help, he will have to do a biopsy now and will have to try and cut where she has the rash and take some blood or something to be sent. The doctor will call with the results to determine what to do from there. The patient did not have any prior vaccinations in 4 weeks. The patient underwent lab tests and procedures which included: on an unknown date in June2021, blood cholesterol was high, blood glucose was normal, blood pressure measurement: 95 mmhg, blood test was normal, thyroid function test was normal. Doctor wanted her to go in for lab work. She had an annual check-up Jun2021 and had blood work done. Her thyroid, blood sugar, and cholesterol were checked. She stated everything was normal except her cholesterol was kind of high. The outcome of haemorrhage, skin tightness, swelling, mass, sleep disorder, scratch, blood cholesterol increased was unknown and urticaria, rash, pruritus was not recovered.  Information about lot/batch number has been requested.