Age: 75.0
Sex: F
Vaccine: COVID19
Symptoms: Illness, Pain, Pain in extremity, Sensitive skin, Somnolence
Clinical narrative: had a slight temperature; chills; achy; felt awful; slept most of the day; She got sick on the second day and stayed in bed; arm was sore; Three to five days after the shot she started to have sensitivity on the skin; Three to five days after the shot she started to have sensitivity on the skin, it is progressing and getting worse; This is a spontaneous report from a contactable consumer (patient). A 75-year-old female patient received the second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot Number: EL3247), via an unspecified route of administration, administered in right arm on 24Jan2021 (at the age of 75-year-old) as a single dose for covid-19 immunisation at a new medical centre (Clinic). The patient medical history included ongoing chronic pain because of spine surgeries, allergies (unspecified) and allergy to dust, mold, mildew, trees and grass (her allergies are environmental, and she was taking a daily allergy pill for years and kind of dropped off with that recently to take one less drug), sleep disorder and night terrors. Concomitant medications included naltrexone (4.5 mg) for chronic pain ongoing from on an unspecified date in 2020 (low dose Naltrexone, it was an opioid antagonist and works for pain. It was working on the pain really well until this started in Mar or Apr2020) and was ongoing. LDN gives her night terrors so she was taking half a zolpidem tartrate (AMBIEN). She is trying not to take it more than every third day. When they were really bad, she took Ambien every night. She takes it maybe two or three times a week for sleep. Fluoxetine hydrochloride (PROZAC) at a lowest dose 10mg, omeprazole (PRILOSEC), losartan (6.25 mg daily) (she takes a quarter of the smallest dose), fish oil and colecalciferol (VITAMIN D) and an unspecified vitamin. Patient takes allergy shots (It was an injection for her allergies. She didn't have it for ten days before the vaccine and didn't get it for seven days after. She doesn't have lot number for allergy shots. This last time it was a new vial and it was just a test injection. She hadn't had a real injection since 10 days before vaccine. The patient received the first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot Number: EK9231), via an unspecified route of administration on 03Jan2021 at 13:20 as a single dose for covid-19 immunisation and did not experienced any adverse effect. The patient previously received flu shot in 1996 and got sick once and she thinks as flu. She thinks it was a live virus and she didn't get it for a while. She started to get the flu shot again as she got older. She had two doses of the Pfizer vaccine. She only had the reaction after the second dose. On 24Jan2021, the patient was fine on the first day except her arm was sore. Her arm is bothering her, but it is not from the shot. She may have done something to it. On 25Jan2021, on the second day the patient got sick and stayed in bed, she had slight temperature, chills, achy, felt awful and slept most of the day. On an unspecified date in Jan2021, three to five days after the shot she started to have sensitivity on the skin, it was progressing and getting worse. It is sensitive to touch and to cold. It is at the level of the belly button to the left of the rib cage and goes around to her back. There was no rash or anything like that. It hurts all the time. It sometimes is ok at night. It is a large area and is very sensitive. It was getting worse. On 30Jan2021 when she googled Pfizer and area on stomach skin sore to touch. She was not sure if that is a reaction to the vaccine or not. She takes LDN which is low dose naltrexone. It was working on the pain really well until this started. She was thinking maybe it could be symptoms of the vaccine since it has to do with COVID symptoms. The events did not result in emergency room and physician office (she reported that she was trying to get in to see the physician). The outcome of the event arm was sore was resolved in three or four days (Jan2021) and the rest of the events was unknown.  Follow-up attempts are completed. No further information is expected.