Age: 53.0
Sex: M
Vaccine: COVID19
Symptoms: Pruritus, Urticaria
Clinical narrative: Ankles started itching like he had mosquito bites / itching was out of control; Hives on ankles, hands, trunk, stomach, back, front, feet / hives all over; This is a spontaneous report received from a contactable consumer reporting on behalf of her husband. A 53 years old male patient received the first single dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; lot ER2613, expiry date Jul2021) on 05Apr2021 at around 16:00, in left arm, for COVID-19 immunisation. No other vaccines were given within 4 weeks. Medical history included cold sores. Concomitant medication included valaciclovir hydrochloride (VALTREX) 1 g, 2 tablets when felt cold sore coming on, for cold sores. The patient took Valtrex just once in a while when he got cold sores, since probably 7-8 years ago. On 05Apr2021 at around 19:00 patient ankles started itching like he had mosquito bites. Hives started on the patient's ankles on 05Apr2021, then spread a little on his hands and a little on his trunk. Throughout the night of 05Apr2021, hives started appearing on his trunk, his stomach a little bit and some on his back. Over the course of 06Apr2021 to 07Apr2021, the hives spread to the patient's front, back, hands and feet. The patient worked most of 06Apr2021 and 07Apr2021 and the hives and the itching continued to get worse. The patient had more hives on 06Apr2021 and on 07Apr2021 he had hives all over. The patient's whole body was filled with hives. By 07Apr2021 night, the patient's itching was out of control and he couldn't hardly stand it. The events required physician office visit (urgent care for hives on 07Apr2021) and also emergency room during the night of 07Apr2021 and again on 08Apr2021 morning at 06:00. Caller reported that she and the patient just got back from the emergency room. The patient was starting to itch again. He lasted about 4 hours after getting home last night, 07Apr2021, and then went back to emergency room on 08Apr2021 morning. Nothing had really helped the patient's itching and hives. The medications took a little of the edge off of the patient's itching. They gave the patient an IV at the emergency room visit on 08Apr2021, but he was starting to itch again. The patient received a prescription for prednisone from urgent care (he had to take 60 mg  the first day, 60 mg the second day, and then taper down over 6 days). When the patient finally got the prescription for prednisone filled and the patient was finally able to take the prednisone, he was going crazy from the extreme itching. The patient hadn't eaten and ended up getting sick from the prednisone. First emergency room visit: the patient received a shot of diphenhydramine 50 mg at 11:33 PM and methylprednisolone sodium 125 mg at 11:36 PM on 07Apr2021. The emergency room gave the patient a prescription for doxepin 10 mg every night for 7 days to help the patient relax and so that he could sleep, but they were unable to have the prescription filled last night as the pharmacy was closed. The patient was given a dose of 10 mg of doxepin to go home with so that he could sleep. Second emergency room visit: the patient received diphenhydramine 50 mg injection at 7:54 AM, 20 mg of famotidine at 7:21 AM, 60 mg methylprednisolone at 7:19 AM, and a 500 mL bolus of sodium chloride 0.9% at 7:56 AM on 08Apr2021. The patient was sent home with prescriptions for hydroxyzine pamoate 50 mg, 1 capsule by mouth three times daily as needed for up to 5 days and famotidine 20 mg, 1 tablet by mouth twice daily for 5 days. Hydroxyzine, famotidine, diphenhydramine, methylprednisolone and doxepin had not really helped the patient's hives and itching. The patient was still trying to recover at the time of report.  No follow up attempts are possible. No further information is expected.