she may have just been dehydrated; physician ordered lab panels to check her electrolytes/ it was possible that the Covid-19 vaccine may have thrown off some of her numbers; right lower eye lid was twitching/ looked more like it was pulsing/ involuntary twitch/ beating under her eye; This is a spontaneous report received from contactable reporter (consumer or other non-healthcare professional) from the medical information team for a Pfizer-sponsored Program (159558). The reporter is the patient.   A 58-year-old female patient received the first dose of bnt162b2 (BNT162B2) via an unspecified route of administration, administered in the left arm on 11Mar2021 10:00 (batch/lot number: EN6027) at the age of 58 years old as DOSE 1, SINGLE for COVID-19 immunization. The patient received vaccination at a Pharmacy Vaccination Facility Type and not at a Facility. Relevant medical history included: "Multiple myeloma", start date: Feb2019, stop date: 2020, notes: in remission; "bone marrow transplant", start date: Nov2019, stop date: Nov2019, notes: autonomous bone marrow transplant; "Immune system disorder" (unspecified if ongoing), notes: bone marrow transplant wiped out a lot of her immunity; "Dry eyes" (ongoing), notes: her eye doc said she  always had dry eyes; "Eye doctor visit", start date: 2017, stop date: 2017, notes: she last saw her eye doctor in 2017; "TIA", start date: May2019, stop date: May2021; "shingles", start date: 2020 (unspecified if ongoing); "cancer" (unspecified if ongoing), notes: she was very susceptible; "hair and stuff" (unspecified if ongoing); "low on d-2 in her body", start date: 2020 (unspecified if ongoing); "Vaccinations" (unspecified if ongoing), notes: No AEs following prior vaccinations. Patient had no family medical history relevant to AEs. Concomitant medications included: REVLIMID taken for multiple myeloma, start date: 2020 (ongoing); VALACYCLOVIR HCL taken for Shingles, start date: 2020 (as reported); XARELTO taken for transient ischaemic attack, start date: Jun2019 (ongoing); BIOTIN taken for hair and stuff, start date: 2020 (ongoing); VITAMIN B12 [CYANOCOBALAMIN], start date: 2020 (ongoing); VITAMIN D2 taken for low on d-2 in her body, start date: 2020. The following information was reported: BLEPHAROSPASM (non-serious) with onset 12Mar2021 18:00, outcome "recovered" (17Mar2021), described as "right lower eye lid was twitching/ looked more like it was pulsing/ involuntary twitch/ beating under her eye"; DEHYDRATION (non-serious), outcome "unknown" described as "she may have just been dehydrated"; ELECTROLYTE IMBALANCE (non-serious), outcome "unknown" described as "physician ordered lab panels to check her electrolytes/ it was possible that the Covid-19 vaccine may have thrown off some of her numbers." The events were evaluated at the physician office visit. Relevant laboratory tests and procedures are available in the appropriate section. Therapeutic measures were taken as a result of blepharospasm, dehydration, and electrolyte imbalance.  The clinical course was reported as follows: She received the first dose of the Pfizer COVID-19 vaccine on Thursday 11Mar2021. The next evening, Friday 12Mar2021, her daughter noticed that her right lower eye lid was twitching. When she looked at her eye in the mirror, it looked more like it was pulsing, "like as if a vein were pulsing." She has seen her primary care provider, her eye doctor and has reached out to her oncologist as well. Her primary care provider encouraged her to call and report this side effect to Pfizer. The caller would also like to know if there have been other reports similar to hers. Patient reported that on the evening of Friday, 12Mar2021, around 1800, she started developing a twitch under her right eyelid. She could not see or feel the twitch and that it was involuntary, almost like a pulsing. Her daughters were noticing the twitching. The whole weekend she wondered who she should call. She called Pfizer and pharmacy over the weekend; she was not able to get ahold of anyone at Pfizer. In the meantime, she made appointment with her primary care physician and eye doctor. Her doctor called it a twitch, but stated it was more like a pulsing, that it felt more like a beating under her eye, like a rapid beating. Patient stated that it was very noticeable. Nothing like this has ever happened to her before. The eye twitching occurred all weekend and was still twitching yesterday, 16Mar2021. As of today, 17Mar2021, her eye has stopped twitching. She is hesitant to say that she has recovered as it could begin again, but that she thinks that she has recovered. She stated that she doesn't want to speak too soon. She was applying warm compresses to her eye. She followed her eye doctor's instructions, drinking water and using lubricating eye drops, and God willing it's resolved. She stated that she may have just been dehydrated. Her eye doctor was really perplexed, that he has been in business a long time and said that he thought it could be due to dry eyes or it could be a reaction from the vaccine with one of her other medications. Her eye doctor told her to drink a lot of water and use lubricating eye drops. Patient stated she had no other side effects, no headache, fever, arm soreness. Her physician ordered lab panels to check her electrolytes. She stated that he thought it was possible that the Covid-19 vaccine may have thrown off some of her numbers and stated that she probably wasn't drinking enough water. She did not have results yet from the labs drawn by her physician. Patient further reported she was scheduled for her second dose 28 days later instead of 21 days. Her sister received the Pfizer COVID vaccine at pharmacy and she was scheduled for 21 days later. She would like to know if it is okay to receive the second dose at 28 days or should it have been 21days? She also stated she was afraid that by receiving the second dose greater than 21 days from the first dose she might have another reaction. Patient's second vaccine is scheduled for 08Apr2021. She doesn't understand how 2 different pharmacies can be doing 2 different days and asked if is there a problem with that. She also asked for clarification on the correct dosing schedule. Second dose was scheduled for >21 days: Her next vaccine is in 28 days, scheduled for 08Apr2021.  No follow-up attempts are needed. No further information is expected.