Age: 78.0
Sex: F
Vaccine: COVID19
Symptoms: Pain in extremity, Pyrexia, SARS-CoV-2 test
Clinical narrative: Headache; Low grade fever; Arm soreness; Chills; Nausea; This is a spontaneous report from a contactable consumer (reported for herself). A 78-years-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE, Solution for injection, Lot Number: EN6204, expiry date not reported), via an unspecified route of administration, administered in the left arm on 08Mar2021 16:00 (at the age of 78 years old) as dose 1, single for covid-19 immunisation. Medical history included ongoing A-Fib (atrial fibrillation); ongoing blood disorder; broken back from 2020 to an unknown date; covid from Oct2020 to an unknown date; ongoing restless leg; stomach/irritable bowel syndrome from an unknown date and unknown if ongoing; and urinary tract infection (reported as prevention of UTI) from an unknown date and unknown if ongoing. Patient took the covid vaccine because of age and has autoimmune problems, has A-fib. Concomitant medications included apixaban (ELIQUIS) taken for atrial fibrillation from an unspecified start date and ongoing (reported as started five years ago), orally at 5 mg, twice a day; pramipexole (0.125 mg strength) taken for restless leg from an unspecified start date and ongoing (reported as last year, not sure exactly when), orally at 0.125 mg, twice a day; amiodarone taken for atrial fibrillation from Feb2021 and ongoing (reported sa she thinks she started the medication last month), orally at 200 mg, once a day; cephalexin [cefalexin] taken as prevention of UTI from Feb2021 to an unspecified stop date (reported as started this particular one a couple of months ago, this has Feb2021 was on it), orally at 500 mg, weekly  (one a week); potassium taken for atrial fibrillation, start and stop date were not reported (from several years ago, not sure just when, probably been 3 or 4 years), orally at 10 meq, once a day; esomeprazole taken for stomach/irritable bowel, start and stop date were not reported (reported as last year sometime she thinks), orally at 40 mg, twice a day; methocarbamol taken for back broke, start and stop date were not reported, orally 750 mg, once a day, as she back broke twice last year, so she was taking this to help (she takes one at night, but if it was hurting she takes more, it helps); and diltiazem taken for atrial fibrillation, start and stop date were not reported (did not know when she started this), orally at 120 mg, as needed. Patient received her first dose of the Covid vaccine, on 08Mar2021, afternoon at about 4:00 PM. On 08Mar2021, patient had chils and nausea. On 09Mar2021, the patient experienced headache, low grade fever, and arm soreness. Patient stated that the chills started yesterday/last night (08Mar2021) and everything else started this morning (09Mar2021). She started feeling a little nauseated yesterday (08Mar2021). Her second dose is scheduled for 29Mar2021. Therapeutic measures were taken in response to the events reported which included she took Tylenol 500 mg, 2 tablets, she reports she takes 2 at night. The Tylenol (Acetaminophen 500 mg tablets; Exp: Nov2022) has not done anything for the headache, however, she stated the fever may be down a little bit because she wasn't cold right now. Patient reiterated the Tylenol just didn't help her headache and it usually helps, but not with this headache. Patient also noticed that her arm was sore this morning (09Mar2021), she put ice on it yesterday. It was not swelled, just really sore. Patient checked temperature before calling, 99.4 F and she has not checked it again. Initially stated no relevant tests while going through the report, she stated she had 2 weeks ago (in Feb2021) negative covid rapid test. The events were reported as non-serious. The events did not require emergency room or physician office visits. The patient was recovering from chills, low grade fever and nausea (reported as patient was still feeling a little nauseated- improved a little but not much).  The outcome of the events headache and arm soreness was not recovered.   No follow-up attempts are possible. No further information is expected.