Age: 64.0
Sex: M
Vaccine: COVID19
Symptoms: Body temperature, COVID-19, SARS-CoV-2 test
Clinical narrative: Tested positive for Covid with symptoms; This is a spontaneous report from a contactable consumer (patient). A 64-year-old male patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE; lot number and expiration date unspecified), intramuscular, administered in left arm on 29Mar2021 15:45 as single dose for COVID-19 immunisation. Medical history included cholesterol (abnormal), little light headed and high blood pressure. Concomitant medications included acetylsalicylic acid (ASPIRIN) taken as Blood thinner and placed on aspirin for the last 4 years at least, if not more; ongoing atorvastatin for cholesterol and initially he stated he started Atorvastatin 6-12 years ago but then states the medication for cholesterol was started within the last 3-4 years; ongoing lisinopril for little light headed when he was doing physical therapy, like when he would get up real quick, but now his doctor has him back on it; ascorbic acid (VITAMIN C) taking it for 20 or 30 years, tocopherol (VITAMIN E), vitamin d nos and a multivitamin in which he started taking at age 50 and mentioned the bottle saying NON-GMO, gluten free, and has a breakdown of everything. On 05Apr2021, the patient was tested positive for covid. The health department said he was clear of that now. He had 2 tests done for Covid. He had the first rocket testing 05Apr2021. The patient reported that he takes medications, but he doesn't think it affected anything or gave him Covid. As of Thursday, 08Apr2021, he got the monoclonal antibody treatment via IV. His symptoms were pretty mild. Just a heavy chest, his coughing was not persistent by any means. Once in a while he will cough and he will expel something/discharge so he imagines there was still some lingering effect or remnants thereof. He really didn't think he had COVID that bad. He had fever for the first 2 days. So, it was hard to say if something was lingering. He had slight fatigue but doesn't feel overly tired, but he was not doing anything physical. He just has a little bit of a cough. He didn't feel the heavy chest much at all. He was worried about the respiratory part. He never felt that he was wheezing. Towards the tail end, he felt like something was there a little bit of congestion possibly. People say he sounded 100% better on the phone he doesn't sound nasally or stuffed. His heavy chest is nothing as it has been in the past. He was worried about getting Covid because of the respiratory problems. It started about the 5th day. if at all. It's hard to say when the "heavy chest" began because it's hard to say it really was there. It is the only thing lingering and that has him paying attention to it. He doesn't know if his chest really feels all that heavy, but he knows the more he can get out/expel, the freer his lungs will be. He tries to pay attention to it to see if he's building anything, which he doesn't think he is. He wouldn't say its really that heavy. It wasn't bothering him on the 05Apr2021, but possibly on 09Apr2021, he could tell there was some residual in his lungs. His cough was mostly when he breathes deep. It has been for the last 4 days. If he breathes deep he can feel a little restriction, like he doesn't have full capacity or the fact that he hasn't done anything physical. So, then he feels like a little tickle that will agitate it to make him want to cough. He doesn't believe he had any headache. He had a fever the day before he got the test. The fevers have resolved at this point. The fevers were on Monday and Tuesday- his temperature was 100.3 and the day earlier it was 101.8, both fevers were in the evening. He took Theraflu, and since then his temperature has been 98, 99, and lower. He doesn't think he is dehydrated. He has not done anything too physical to know if he felt weak. He asked the doctor after if it was safe to follow up with the 19Apr2021 second Covid shot. His doctor said yes, but the nurse who administered the IV said he should wait 90 days. He thought originally with the Covid, they talked about no COVID shots until 90 days after having COVID. But since he had the "cocktail" he doesn't know if that expediates it or the fact that he put this stuff in. Either way, he needs someone to give a straight answer, and if he gets 2 out of 3 people telling him the same answer, he guesses he will go that route. Outcome of event was unknown.   Information about lot/batch number has been requested.