Age: 67.0
Sex: M
Vaccine: COVID19
Symptoms: Epistaxis, Fatigue, Haemorrhage, Hypersensitivity, Investigation
Clinical narrative: low platelets/ platelet count was 10; sore arm; purple blood bruises; thought they were allergies; nosebleeds; he had red dots on legs and feet but blood coming through; he had red dots on legs and feet but blood coming through; very weak and tired; very weak and tired; This is a spontaneous report received from a contactable reporter (Consumer or other non HCP) from medical information team.  A 67-year-old male patient received BNT162b2 (BNT162B2), on 23Jun2022 as dose 4 (booster), single (Batch/Lot number: unknown) at the age of 67 years, in right arm for covid-19 immunisation. The patient's relevant medical history included: "medical condition with the lungs", start date: 2017 (ongoing), notes: had oxygen for that and that was stable; "oxygen" (unspecified if ongoing); "wheelchair" (unspecified if ongoing), notes: before the covid vaccine; "paralyzed lung" (unspecified if ongoing), notes: that had been stable; "heart issues" (unspecified if ongoing). The patient took concomitant medications, which included an unspecified heart medication in the mornings and it was a low dose of it. Past drug history included: Sertraline for Depression, reaction(s): "probably messing with the platelets"; Hydroxizine, notes: taking heart medication in the mornings and it was a low dose of it. Vaccination history included: BNT162b2 (DOSE 1, SINGLE, Lot number: ER8737), administration date: 24May2021, when the patient was 66-year-old, for Covid-19 immunization, reaction: "sore arm"; BNT162b2 (DOSE 2, SINGLE, Lot number: EW0170), administration date: 14Jun2021, when the patient was 66-year-old, for Covid-19 immunization, reaction: "sore arm"; BNT162b2 (DOSE 3 (BOOSTER), SINGLE, Lot number: 33130BA), administration date: 21Dec2021, when the patient was 66-year-old, for Covid-19 immunization, reaction: "sore arm". The following information was reported: ASTHENIA (non-serious), FATIGUE (non-serious) all with onset Jun2022, outcome "recovered" (2022) and all described as "very weak and tired"; HAEMORRHAGE (medically significant), RASH MACULAR (non-serious) all with onset Sep2022, outcome "unknown" and all described as "he had red dots on legs and feet but blood coming through"; EPISTAXIS (non-serious) with onset Sep2022, outcome "recovered" (Oct2022), described as "nosebleeds"; HYPERSENSITIVITY (non-serious) with onset Sep2022, outcome "unknown", described as "thought they were allergies"; PLATELET COUNT DECREASED (hospitalization, medically significant) with onset 28Sep2022, outcome "not recovered", described as "low platelets/ platelet count was 10"; PAIN IN EXTREMITY (non-serious), outcome "unknown", described as "sore arm"; CONTUSION (non-serious), outcome "unknown", described as "purple blood bruises". The patient was hospitalized for platelet count decreased (start date: 03Oct2022). The event "low platelets/ platelet count was 10" required emergency room visit. The patient underwent the following laboratory tests and procedures: Biopsy bone: (unspecified date) Unknown results, notes: waiting the results that were not back yet; the bone biopsy was probably 2-3 weeks ago; Blood test: (unspecified date) great and fine; (unspecified date) it did not show he had cancer; (Jun2022) clear and good, notes: in the week of the beginning of June; Body height: (unspecified date) 5 feet 10 inches, notes: supposed to be 5 feet 10 inches; whole bunch of tests: (unspecified date) it came back negative; Platelet count: (unspecified date) platelet count becoming really really low; (2022) low, notes: this was ongoing and not improved; (28Sep2022) down to 10, notes: low and critical; Scan: (10Nov2022) Negative, notes: got his very last scan and not sure if it was MRI or cat scan, but it was for his brain to see if it was hemorrhaging and the scan was negative; Weight: (unspecified date) 250 lbs, notes: maybe 250 pounds. Therapeutic measures were taken as a result of platelet count decreased. Clinical course: The reporting patient's daughter was seeking information for her father, who had received 4 doses of the Pfizer Covid 19 vaccine. The patient was hospitalized with low platelets. She would like to know if there was any information available of reports of the Pfizer Covid 19 vaccines causing low platelets in others. The patient had red dots on legs and feet, but blood coming through. The doctors were not sure what else to do. They were awaiting a bone marrow biopsy. The 4th dose of the vaccine was administered because the patient did not want to get sick or get covid from anyone. The patient got sick from the Pfizer COVID-19 vaccine and he was in the hospital for more than a month. The reporter mentioned that the patient was on his death bed and the reporter was very desperate to keep the patient alive and wanted to know who could help her. The patient went to get the 1st vaccine and got the 2nd, 3rd and 4th doses of vaccine and before he got the 4th dose, his primary care doctor from the clinic did blood tests for everything to see if he was great and was fine. When he had his blood drawn in the week of the beginning of June, it was clear and good and they said he could get the other vaccine; he was homebound and wanted to be safe and the reporter asked him if he was sure he wanted to get the 4th one, because he had gotten three and he was good and the reporter also told him that no one goes around him and they were clean and sanitized and wear masks. The patient insisted on getting it and felt like getting vaccines and was good and the reporter got hers too they were not around anyone. The reporter told the patient she did not feel they needed to get more, because they had been completely away from everyone. Right after the patient got the vaccine done, the first four days or 3 to 4 days after that, he was very weak and tired and she had to wake him up from bed and then it went away after the 4th day all of the weakness and tiredness went away and he was fine. The patient had other underlying health conditions that were under control. The previous other three covid vaccine didn't do anything to him. He always got his blood drawn and they checked everything especially with him going to the clinic and he was fine with the other vaccines and had three other covid vaccines that were Pfizer and he had no symptoms with those and only had a sore arm for all four doses of the vaccine, but the sore arm only lasted for the first 24 hours with the first three vaccines and then he was good. The patient was admitted to the hospital on 03Oct2022 due to the low platelets and since he had been in the hospital, the doctor was trying to figure out what was wrong and they were taking away his medications and thought that he could be one in a million, so they changed everything and he went in there because his blood platelets in 28Sep2022 was down to 10, which was low and critical and they said he needed to go to the hospital, because if he would fall down, he would die and bleed out; the reporter was wondering why he had these purple blood bruises or if they were from when he knocked on his wheelchair. The doctor at the hospital was trying everything and they gave him platelets and he was currently receiving blood transfusions and hemoglobin and all that they were giving to him to keep him alive and every day they would check his blood; he had been in the hospital since 03Oct2022 and the reporter was asking for anything, because she had been reading a lot about Pfizer and how people died with the platelet count becoming really really low. She thought the hospital would be calling, because they were concerned that he would not get better and he wanted to get better, but he's not ready. For the medications, the reporter said they changed or took him off. She clarified that the only one she knew about was that they took him of Sertraline, because it was probably messing with the platelets and he was one in a million and if he had a reaction they would remove it and he was off of it for a long time. They gave him platelets and said he should improve, but they did not see improvement. He started taking Sertraline in June and that was at the same time he got the covid vaccine 2nd dose. They told her to get rid of the Sertraline and the patient had not restarted it and they had him on something else really low dose and it was Hydroxizine and that was the only one the doctors said he could be on, because they mentioned all antidepressants could cause platelet issues for people that had current issues with platelet problems, so he was on that for a very low dose. Before he started to have platelet issues or around that time in Sep2022, he started to have nosebleeds that would not stop and he never had nose bleeds and they took an hour or four hours and she thought they were allergies; the nosebleeds were not ongoing and have stopped since he had been at the hospital and gave him a lot of testing every single day. When he first got the vaccine for four days, he was weak and tired and that started up again in the same time as the nose bleed started and he got fatigued and said he needed to do exercises. He was taking a heart medication in the mornings and it was a low dose of it, but she told maybe he might have heart issues and was tired and just fatigued and so he would do exercises with arms, because he was in a wheelchair and he did low impact with her and would be fine and not tired anymore and it happened about 5 times; clarified he was in a wheelchair before the covid vaccine. The platelet count was low and this was ongoing and not improved and they said to him he cannot leave the hospital because if he did, he will die. In September, he started to get  those blood on the legs and they felt and look like where the blood was coming out and it was looking like it was secreting out of the legs and feet and out of the pores and that was controlled. They had been replacing the hemoglobin and this was the 5th round or 4th round of blood transfusions; they were giving him MRIs and CAT scans to make sure he was not having hemorrhaging in the brain; he got his very last scan and she was not sure if it was MRI or CAT scan, but it was for his brain and it was yesterday and they were wanting to see if it was hemorrhaging and the scan was negative. They gave him a bone biopsy to see if he had cancer, but they had done blood work and it did not show he had cancer and they were waiting the results that were not back yet; the bone biopsy was probably 2-3 weeks prior reporting and it would take long to get it back from the Clinic; they said they actually did a whole bunch of tests to rule out what would make the platelets go down and it came back negative; the only thing she could think of was right after he got the 4th dose of Pfizer Covid vaccine was when he started having issues. The medical conditions he had before he got sick with this was he was going into the doctor and getting regular checkups and whatever condition he had was stable what they were giving for medications before June 6th everything was in stable condition before that stuff. She was waiting for the doctor to call for advice to give, because the doctor at the clinic said they were not allowed to call Pfzier and she did not know why Pfizer wouldn't give advice or information. He said he was too young to die and he wanted to live. He had medical conditions that had not caused platelet issues; when he was at the doctor they checked everything and always checked constantly and said he should be fine and the medications he was on right then were perfect and good for him and the only two questionable ones related to the platelets were the Sertraline and the Pfizer Covid vaccine. The reporter would ask for a list of everything they did in the hospital or the doctor, because they changed him weekly and clarified they changed doctors and he had seen one for when you bleed a lot and that doctor was a blood specialist and there were so many doctors; she had to take him to the emergency room at the hospital so that was on 03Oct2022 and they said he would be staying there, because they saw his numbers and he was not going home and it was too dangerous to go home. The vaccination facility was at the clinic. The patient had no prior vaccinations (within 4 weeks). There were no family medical history relevant to the adverse events (AEs).  The information on the batch/lot number for BNT162b2 has been requested and will be submitted if and when received.