TSH 5.8 (range 0.4-5.0); headache; sore arm; tiredness; This is a spontaneous report received from a contactable reporter(s) (Nurse). The reporter is the patient.  A 71-year-old female patient received BNT162b2 (BNT162B2), on 23Jan2021 as dose 1, single (Batch/Lot number: unknown) at the age of 71 years intramuscular, in left arm for covid-19 immunisation. The patient's relevant medical history included: "Graves' disease", start date: 2010 (unspecified if ongoing), notes: Graves' disease treated with radiation in 2010 Thyroid supplemented.; "nuts" (unspecified if ongoing); "citric acid" (unspecified if ongoing); "antibiotics" (unspecified if ongoing); "paraben preservatives" (unspecified if ongoing); "Allergy" (unspecified if ongoing); "I already had body ache, extreme tiredness, and shortness of breath symptoms with the low thyroid" (unspecified if ongoing); "I already had body ache, extreme tiredness, and shortness of breath symptoms with the low thyroid" (unspecified if ongoing); "I already had body ache, extreme tiredness, and shortness of breath symptoms with the low thyroid" (unspecified if ongoing); "I already had body ache, extreme tiredness, and shortness of breath symptoms with the low thyroid" (unspecified if ongoing); "Multiple food and medication allergies that present with skin rash or headache" (unspecified if ongoing); "Multiple food and medication allergies that present with skin rash or headache" (unspecified if ongoing), notes: Multiple food and medication allergies that present with skin rash or headache. The patient's concomitant medications were not reported. The following information was reported: BLOOD THYROID STIMULATING HORMONE INCREASED (non-serious) with onset 12Feb2021, outcome "unknown", described as "TSH 5.8 (range 0.4-5.0)"; HEADACHE (non-serious) with onset 2021, outcome "recovered" (2021); PAIN IN EXTREMITY (non-serious) with onset 2021, outcome "recovered" (2021), described as "sore arm"; FATIGUE (non-serious) with onset 2021, outcome "recovered" (2021), described as "tiredness". Relevant laboratory tests and procedures are available in the appropriate section.  Additional information: Prior vaccinations reported as None. No covid illness found. Patient medical history included Multiple food and medication allergies that present with skin rash or headache. Examples: paraben preservatives, antibiotics, citric acid, onions and garlic, and nuts. No history of asthma. No known active case of covid. Immediately after each vaccine patient had the expected reaction of headache, sore arm, and more tiredness, which cleared within 48 hours. However, after the first vaccine on 23Jan2021 patient found the headache returned. She already had body ache, extreme tiredness, and shortness of breath symptoms with the low thyroid, so she did not consider other causes. She began to feel better the end of Aug and was returning to my previous activities. As of the beginning of Apr2021, most of the tiredness and shortness of breath have significantly lessoned. Inhalers are used as needed. The patient underwent the following laboratory tests and procedures: Alanine aminotransferase: (20Nov2021) Nl; Aspartate aminotransferase: (20Nov2021) Nl; Blood alkaline phosphatase: (20Nov2021) Nl; Blood bilirubin: (20Nov2021) Nl; Blood thyroid stimulating hormone (0.4-5.0): (27Dec2020) 16.5; (12Feb2021) 5.8; (23Dec2021) 6.3; Chest X-ray: (02May2021) Dependent atelectasis. Albuterol and Alvesco start; (11Nov2021) Nl; Computerised tomogram: (26Apr2021) Nl; C-reactive protein: (20Nov2021) Nl; Echocardiogram: (15Feb2021) Nl; Electrocardiogram: (08Feb2021) Nl; Exercise electrocardiogram: (24Mar2022) Nl; Full blood count: (24Mar2021) Nl; (27Dec2021) Nl; Pulmonary function test: (06Jul2021) Low Normal; Red blood cell sedimentation rate: (20Nov2021) Nl; SARS-CoV-2 test: (08Feb2021) Negative; (Aug2021) Negative, notes: PCR repeated every 2 wks between Aug2021 and Dec2021 for work - all tests neg; (Sep2021) Negative, notes: PCR repeated every 2 wks between Aug2021 and Dec2021 for work - all tests neg; (Oct2021) Negative, notes: PCR repeated every 2 wks between Aug2021 and Dec2021 for work - all tests neg; (Nov2021) Negative, notes: PCR repeated every 2 wks between Aug2021 and Dec2021 for work - all tests neg; (Dec2021) Negative, notes: PCR repeated every 2 wks between Aug2021 and Dec2021 for work - all tests neg so symptoms were not from covid virus.; Thyroid function test: (unspecified date) negative, notes: Thyroid test were negative; Vitamin B12: (20Nov2021) Nl. She hopes that all the symptoms resolve. She was reluctant to get another Pfizer booster. She was asking considering her history of allergies, is it possible to have allergy testing to ingredients in the Pfizer vaccine? Reporter considered the Pfizer product had a casual effect to the adverse event.  The information on the batch/lot number for BNT162b2 has been requested and will be submitted if and when received.