Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Anxiety, Depression, Epistaxis, Fear, Fear of injection
Clinical narrative: spitting up phlegm- draining going down the back of her throat and makes her gag, pinkish color in it- little specs of bloo; spitting up phlegm- draining going down the back of her throat and makes her gag, pinkish color in it- little specs of bloo; INR- 10Mar2021- 6.20 Normal Range:2-3/ It was 6.20 the next week too; Blood coming out of nose; caller has been having depression, clarified since before the shot, and it's getting worse; forgetfulness; she has been overanxious; she is afraid of everything; she didn't want to get the shot because she was afraid; This is a spontaneous report from a contactable consumer (patient). A 69-year-old female patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Lot Number: EN6206), intramuscular, administered in Arm Left on 10Mar2021 at around 3:00- 4:00 PM (15:00-16:00) (at the age of 69-year-old) as single dose for COVID-19 immunization. Medical history included blood clots before in her leg (ever since she's been on warfarin she hasn't had any; been years since she had been diagnosed); Mini stroke- TIA from 05Jan2011 (had to be like 2 years before she retired. Retired in 2013); Ongoing Blood pressure diagnosed around 2013 and blood pressure was getting better; Stripped veins (Does not know when she had this done, around 2013); she broke her ankle in 1998 getting off the school bus; depression. The patient had no family medical history relevant to AE(s). Concomitant medication(s) included warfarin taken for blood thinner from an unspecified start date and ongoing; lisinopril taken for blood pressure from an unspecified start date and ongoing (had been taking this for quite a while; if she keeps losing weight, he could take it off); escitalopram taken for an unspecified indication, start and stop date were not reported. The patient had no history of previous immunization with the Pfizer vaccine considered as suspect (or patient age at first and subsequent immunizations if dates of birth or immunizations are not available). The patient had no other additional vaccines administered on same date of the Pfizer Suspect. She had no prior Vaccinations (within 4 weeks) and AE(s) following prior vaccinations. The patient previously took iodine and had allergy. The patient received the Covid-19 shot two weeks ago on 10Mar2021. Patient reported that she made a mistake and did not tell them she was on warfarin. She had the shot and when she was driving home directly after, about 20 minutes after she had the shot, blood started coming out of her nose. Patient stated it wasn't a lot but enough to shake her up. When the doctor checked her INR, it was 6.20, they said it was high and it should be at 2-3. Patient reported the doctor had her on half of warfarin for now, at supper time. She had been taking warfarin 20 years, the doctor cut back taken at night when she went to bed- 1 pill a meal. Patient reiterated that she didn't get a chance to tell them that warfarin was one of the medications that she takes. Patient was wondering if the nosebleed could be from the shot. Patient mentioned that she was prone to blood clots; she was on warfarin so she doesn't get blood clots. Her sister called the pharmacy, not the one that gave the shot, because she was nervous and upset. The pharmacy said they didn't think that was a reaction, but they thought it was odd because one other person had a nosebleed too. Patient reported when they go to test her to see what range she is for INR, it wouldn't come out and they had to push. Patient explained that on 10Mar2021 she went to the pharmacy type thing, they pricked her finger to see what her level was, it went clear up to 6.20. The next week, it did it again. It was 6.20 the next week (Mar2021) too. She had not been told what was going on. They haven't told her what to do other than they told her to eat more green food. They did tell her about what foods she shouldn't and should be eating. Caller wanted to know what the INR was. Patient reports she has had blood clots before in her leg and she gets all shook up. Patient reported that today (19Mar2021) she had an episode. She was not sure if it was from the shot- but she had a nosebleed this morning (19Mar2021). Patient reported that it was on her mask and it's been going off and on. This morning (19Mar2021) around 8 AM, she started spitting up phlegm- it was draining and going down the back of her throat and makes her gag, it has a pinkish color in it- little specs of blood. She had seen a light dribble on mask and she started spotting again. They reported that the patient has been having depression, clarified since before the shot, and it's getting worse- she's been experiencing forgetfulness, she was afraid of everything, she didn't want to get the shot because she was afraid, she has been overanxious. Patient reported her new pill was called escitalopram, 10 mg one a day by mouth, half tablet at bedtime. Patient states that this was prescribed on the same day as the vaccine. Patient clarified she started this after receiving the vaccine and didn't take it for like three days or something because she had to wait. Patient was scheduled to receive her second dose on 31Mar2021. Patient wanted to make sure she can get it and not have any reaction and be safe. Patient reiterated she just wanted to make sure it's not a reaction to the vaccine and she can get the second dose. AE(s) did not require a visit to Emergency Room or Physician Office. Outcome of the event nose bleed was recovering; spitting up phlegm- draining going down the back of her throat and makes her gag, pinkish color in it- little specs of blood was recovered on 19Mar2021; other events was unknown.  No follow-up attempts are possible. No further information is expected.