on 01Apr, got sick and was diagnosed Covid positive on 05Apr2021/ he had a fever and all the usual symptoms/fever, body aches, lost sense of taste and smell, diarrhea, stomach cramps, and vomiting; Patient History: Pemphigus (From: Unspecified To: Ongoing)/ Pemphigus came back because of the Covid virus; Patient History: Pemphigus (From: Unspecified To: Ongoing)/ Pemphigus came back because of the Covid virus; This is a spontaneous report from a contactable consumer (patient's father).  A 42-year-old male patient received his first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: ER2613) at the age of 42-years-old, via an unspecified route of administration in left arm on 20Mar2021 at 17:32 at single dose for COVID-19 immunization.  Medical history included ongoing autoimmune disease called pemphigus since 2016 (about 5 years ago), he had a flare up before the first vaccine. The same year the patient was diagnosed with pemphigus, he got a flu shot and had X-rays. They were told that the disease may be more related to getting the X-rays, but that was uncertain. The patient also has ongoing obesity since 2006 (15 years ago); and ongoing intellectual disability which started when he was a child.  Concomitant medications included ongoing prednisone for pemphigus and ongoing dapsone as prednisone sparring medication (as reported). There were no additional vaccines administered as the same date as BNT162B2 and no prior vaccinations within 4 weeks. The patient previously received a flu shot on 2016, the same year pemphigus was diagnosed. The patient tested positive for COVID-19 on 05Apr2021 after his first COVID-19 vaccine dose on 20Mar2021 (also reported as 05Mar2021) which was administered at a vaccine clinic put together by a pharmacy. It was further stated that on 01Apr2021, he got sick and was diagnosed as COVID-19 positive on 05Apr2021 at 11:00. He had a fever and all the usual symptoms of COVID including body aches, lost sense of taste and smell, diarrhea, stomach cramps, and vomiting. They took him to an urgent care to get tested for COVID. Because the patient was isolating, he missed his second COVID vaccine. He was isolated for 2 weeks and went back to work. The patient was pretty bad for 3 days and then he slowly got better. It took him a week after his initial sickness to get back to normal. The patient has as an ongoing autoimmune disease called pemphigus and he was taking prednisone 10 mg orally and then tapered off and was on none for 5 days prior to receiving his first vaccine dose. He then restarted his prednisone at 5 mg, then 10 mg, and then back to 20 mg orally daily. Because of the COVID virus, pemphigus came back on Apr2021. The patient was on rituximab and it was used off label to help with the patient's pemphigus. The medication would reset the patient's immune system. He had a flare up, before the first vaccine, and the patient took two rounds of the medication and then took prednisone, which was tapered off before his first vaccine. The patient's father asked when can the patient get his second vaccine after testing positive for COVID-19 and if there were any interactions with prednisone and the vaccine. The patient's father called the facility where the patient got the first vaccine, and they told him at first to wait 2 weeks, then they told him to wait 4 weeks. The patient has an appointment on 01May2021 to be vaccinated. Predisposing factors for lack of efficacy (as reported) were reported as autoimmune disorder and the patient has been going out and not socially distancing. Culture was not performed, and antipyretic was not used. The outcome of the event COVID-19 was recovering and unknown for all other events.