Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Cyanosis, Haematocrit, Haemoglobin, Mammogram, Palmar erythema
Clinical narrative: Fingers were turning blue; Palms turned bright red; she was diagnosed with Raynaud's; The initial case was missing the following minimum criteria: unspecified adverse event. Upon receipt of follow-up information on 07Jun2021, this case now contains all required information to be considered valid.  This is a spontaneous report from a contactable other healthcare professional (hcp; patient). A 68-years-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE, Solution for injection, Lot Number: EL9266, expiry date not reported) via an unspecified route of administration, administered in left arm on 11Feb2021 (at the age of 68 years old) as second dose, single for covid-19 immunization. Medical history included ongoing allergies; ongoing history of anaphylaxis; deficient in Vitamin D; she had a bad pneumonia and was septic and knocked out her immune system and almost died; had allergies to food, dyes, allergy meds; had hypotension (described as "they're neurally mediated hypotension, dyes, could be smells said certain things like that"); MTHFRA1298 positive (described as "it's kind of like a mutation, says when you're homozygous you usually don't have any issues with clotting or bleeding"); and said that food, the red and yellow dyes bottom out her blood pressure. She said that since that time she had pneumonia as per her history, she has had multiple episodes and since COVID affects lungs and she was an HCP, she didn't want to be working until she could take the vaccine. She stated her niece was travelling and she called her doctor to see what he thinks. The doctor said he can't tell you what to do; it was a month or two after the vaccine. The doctor just wouldn't recommend it and said it was not a good idea. She felt awful. She would like to return to work, but she needed to know the chances of surviving because of her lungs and the pneumonia. She stated that the CDC did an investigation in 2006/2007 about this pneumonia and wondered if it was fungal. The CDC had to investigate, said it knocked out her immune system. She never had allergies until that, dyes like red and yellow, and she has all kinds of allergies after that episode. She was not sure how it affected the immune system: the pneumonia and then allergies to food, dyes, allergy meds. Patient reported history as she carried an epi pen since childhood and said her primary concern was wasps, bees, things like that and she was never without it as food, the red and yellow dyes bottom out her blood pressure. The epi pen primarily affected most of the allergies, they're neurally mediated hypotension, dyes, could be smells, said certain things like that. She knows what do when she feels like she's going to pass out. It's managed and she's doing pretty well. Family medical history included some family is heterozygous and have had bleeding and clotting. She, her twin sister and brothers were all homozygous. Her father has had autoimmune issues like ITP, so his platelets weren't forming, and if there was bleeding he had to be careful. There were no concomitant medications; reported as patient doesn't take any medications. The patient had no prior vaccinations (within 4 weeks) or had not had any other vaccinations within four weeks prior to the first administration date of the suspect vaccine and stated she kept away from vaccines because of previous reactions she's had. The patient received the first dose of bnt162b2 for covid-19 immunisation on 21Jan2021 at maybe between 7-7:30, as she said she got in early  (lot number: EL3248), administered in the left arm, and within 24-48 hours after her first injection she had shingles. She also experienced couldn't feel some of her toes; and when she took her shoes off, the toes she couldn't feel were totally white. Patient stated that she was worried and almost didn't get the second dose. She treated the shingles on her own, and said it wasn't so much the burning but was more the itching and blisters all over her back. She used a home remedy of toothpaste for the shingles, and it dried it out and stopped the itching. The shingles were annoying, and her shirt was soaking wet from the blisters; it was awful, but not really disabling. She said that if she went out, she just had to make sure her shirt didn't get soaking we; it was annoying. She didn't go to the hospital because she knew what it was. Patient previously took epinephrine (EPIPEN) since childhood for allergies; and had intermittently took vitamin D for she periodically was really deficient in Vitamin D. On the first dose, she started noticing she couldn't feel some of her toes, and said when she took her shoes off, the toes she couldn't feel were totally white. She had never had that happen before, and she questioned if she should get the second dose or not. She then went and got it. She then started noticing her feet and fingers, her fingers were turning blue and she has pictures of that, too. She had been plagued with this since she got it, she's not saying it's from the vaccine, not 100 percent, but she's never had it and she does now. Her palms turned bright red and all of a sudden, her fingers turned blue on an unspecified date in 2021. She was diagnosed with Raynaud's in 2021, and no one in her family has had it and she has never had it herself. Patient stated that she got the vaccine at the same time as the first (between 7am to 730 am). Her fingers started after the second dose; it might have started before, but she thinks it was after the second dose. Patient stated that she would really like to see if she has any antibodies; she wondered did she mount any kind of response. The events required physician office visit as she visited the doctor due to the toe and finger discoloration, and said it took a couple of months to get an appointment because it was a specialist. The events were reported as serious medically significant but said were not disabling and she went to the doctor. Patient stated that her blood platelets have been fine and both hemoglobin and hematocrit were fine on an unknown date. She doesn't have a PCP, just shows up and does a general, from mammogram to PAP (dates unknown; unknown results), and said it's just a general visit. The outcome of the events was unknown. Patient stated that events reported were related to Pfizer COVID vaccine. Reported said that there was a strong possibility it's correlated, and said that when you look at the time frame and the time period, the fact that it was never there and now it is. The correlation is pretty strong. She never did anything for shingles and said she never had the vaccine.