tested positive for Covid 19/he has had 4 Pfizer shots total and still got the virus; tested positive for Covid 19/he has had 4 Pfizer shots total and still got the virus; This is a spontaneous report received from a contactable reporter(s) (Consumer or other non HCP) from medical information team. The reporter is the patient.  A 71-year-old male patient received BNT162b2 (BNT162B2), as dose 1, single (Batch/Lot number: unknown), as dose 2, single (Batch/Lot number: unknown), as dose 3 (booster), single (Batch/Lot number: unknown) and as dose 4 (booster), single (Batch/Lot number: unknown) for covid-19 immunisation. The patient's relevant medical history and concomitant medications were not reported. The following information was reported: DRUG INEFFECTIVE (medically significant), COVID-19 (medically significant), outcome "unknown" and all described as "tested positive for Covid 19/he has had 4 Pfizer shots total and still got the virus". The patient underwent the following laboratory tests and procedures: SARS-CoV-2 test: Positive, notes: tested positive for Covid 19 today. Therapeutic measures were taken as a result of drug ineffective, covid-19.  Clinical course: The patient tested positive for Covid 19 today (date not specified) and was prescribed standard dosing of Paxlovid. He stated that he has had 4 Pfizer shots total and still got the virus. He would like to know if there are any interaction with his medications: Folic acid, Lisinopril, Prednisone, Sulfadiazine. Paxlovid (nirmatrelvir co-packaged with ritonavir) is a strong inhibitor of CYP3A and may increase plasma concentrations of drugs that are primarily metabolized by CYP3A. Co-administration of Paxlovid with drugs highly dependent on CYP3A for clearance and for which elevated plasma concentrations are associated with serious and/or life-threatening events is contraindicated. Co-administration with other CYP3A substrates may require a dose adjustment or additional monitoring. Co-administration with corticosteroids (all routes of administration) of which exposures are significantly increased by strong CYP3A inhibitors can increase the risk for Cushing's syndrome and adrenal suppression. However, the risk of Cushing's syndrome and adrenal suppression associated with short-term use of a strong CYP3A4 inhibitor was low." Patient questioned if it can be taken with or without food right and received response "Administration Instructions Inform patients to take Paxlovid with or without food as instructed." Patient stated that he was advised by his HCP to take the first dose as soon as he got home today so he took it at 12 noon. He would like to know if he can take the evening dose at 7 pm which would only be 7 hours between doses. He said that maybe he will wait until 10 pm to take it. Relayed to caller that all safety and efficacy information is based on it being taking every 12 hours. There is no information on it being taken at the 7 hour mark. Patient questioned that when will this start to make him feel better and received response "for the treatment of mild-to-moderate coronavirus disease 2019 (COVID-19) in adults and pediatric patients (12 years of age and older weighing at least 40 kg) with positive results of direct severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral testing, and who are at high risk for progression to severe COVID-19, including hospitalization or death. "  The information on the batch/lot number for BNT162b2 has been requested and will be submitted if and when received.