Age: 17.0
Sex: F
Vaccine: COVID19
Symptoms: Pain, Painful respiration, Productive cough, Pruritus, Pyrexia
Clinical narrative: Muscle fatigue in arms, neck, shoulders; Itching left underarm; Lots of phlegm being produced; Lots of fatigue; Stiffness in neck and shoulders; Pounding headache; Pain with deep breaths; 103 deg. fever/ fever subsides to 101 deg. next day; Began with chills; Aches; Headache behind right eye like migraine/ Slight migraine; Significant pain at injection site; Moderately limited movement such as turning over, standing up, laying down; Loss of appetite; Dry mouth; This is a spontaneous report from a contactable consumer, the patient. A 17-year-old non-pregnant female patient received second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration in the left arm on 12Apr2021 at 15:00 (at the age of 17-years-old) as a single dose for COVID-19 immunisation. Medical history included asthma, premenstrual dysphoric disorder (PMDD), depression, anxiety, migraine disorder and allergy to tree nuts (except hazelnut (hazelnuts). Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. Concomitant medications included sertraline (MANUFACTURER UNKNOWN), fluticasone furoate; vilanterol trifenatate (BREO ELLIPTA), vitamin d nos (MANUFACTURER UNKNOWN), vitamin b complex (MANUFACTURER UNKNOWN) and unspecified birth control pill (MANUFACTURER UNKNOWN); all taken from an unknown dates for an unknown indications and unknown if ongoing. The patient previously received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration in the left arm on 23Mar2021 at 17:45 (at the age of 17-year-old) as a single dose for COVID-19 immunisation. On 13Apr2021, at 04:00, the patient experienced chills (began with chills); at 07:00 experienced 103 degrees fever and experienced aches, headache behind right eye like migraine, significant pain at injection site which moderately limited movement such as turning over, standing up, laying down, loss of appetite and dry mouth, but no desire for fluids. Fever subsided to 101 degrees. Next day on 14Apr2021, the patient experienced reduction of pain at injection site significantly, but a stiffness in neck and shoulders and pain with deep breaths; the patient reported the pain subsided until next morning. On 15Apr2021, the patient experienced muscle fatigue in arms, neck, shoulders, itching left underarm, pain with deep breaths (continued after breo was administered), lots of phlegm being produced and lots of fatigue and slight migraine. The patient underwent body temperature tests and the result was 103 degrees (unspecified units) on 13Apr2021 at 07:00 and the result was 101 degrees (unspecified units) on 14Apr2021. The events resulted in doctor or other healthcare professional office/clinic visit. Therapeutic measures were not taken as a result of the events. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events chills, 103 degrees fever, aches, headache behind right eye like migraine, significant pain at injection site which moderately limited movement such as turning over, standing up, laying down, loss of appetite and dry mouth, but no desire for fluids, stiffness in neck and shoulders, muscle fatigue in arms, neck, shoulders, itching left underarm, lots of phlegm being produced and lots of fatigue and slight migraine were resolving while that of pain with deep breaths (continued after breo was administered) was not resolved at the time of this report.  No follow-up attempts are required; information about lot/batch number cannot be obtained. No further information is expected.