crazy blood pressure fluctuations the highest was 188/89/BP was around 159 or 150 then it came down to 136/71; feeling real jittery; hot flush feeling like an adrenaline rush in her upper chest and arms; heart pounding/highest pulse was 106; This is a spontaneous report from a contactable nurse (patient). A 69-year-old female patient received the first dose of BNT162B2 (Pfizer-BioNTech COVID-19 vaccine, lot number: EM5318), via an unspecified route of administration, administered in the left upper arm on 09Feb2021 at 11:00 at a single dose for COVID-19 immunization.  Medical history included premature ventricular contractions (PVC) from an unknown date wherein her pulse goes up into the 120s and had to go to the ER. There were no concomitant medications. The patient previously received Pneumovax 23 on 14Jan2021. The patient called about the Pfizer COVID 19 vaccine. The patient had the shot on 09Feb2021 and the 10th she was fine then on 11Feb2021, she started having side effects. She is calling it side effects but what she is describing, she has these episodes periodically but she has not had one in 2 years but it was bad one and it happened 2 days after her vaccine, she is not sure if it was side effect but she doesn't want to mess with it so she wants to tell someone. On 11Feb2021, the reaction started around 1:30 PM. She started feeling real jittery, she was hot flush feeling like an adrenaline rush in her upper chest and arms down to her elbows. She could feel her heart pounding and she had these before but no one seems to know what causes it. She worked with it she was busy doing other things then around 4PM that day it started getting worse. She could tell her blood pressure was getting involved. She started taking her blood pressure, from 4:30 on until 12:30AM she had crazy blood pressure fluctuations the highest was 188/89 and the highest pulse was 106 but it goes up to 188 and then it would be 158, 179, 155, 119, 166 and those are the top number of the blood pressure. Her pulse pretty much stayed high 80s 90s except for the time it was 106. After midnight, her BP was around 159 or 150 then it came down to 136/71 and her pulse was 78 and she slept much better, she slept for 4 hours she woke up feeling like heart pounding but her blood pressure was 125/69 and her pulse was 74. She also has PVC and sometimes they say when she feels her heart pounding and her blood pressure and pulse are fine, they said that is probably PVC. When her blood pressure and pulse goes way up she is miserable. She had it so that her pulse goes up into the 120s with this and she has had to go to ER before. She clarifies her pulse being in the 120s and having to go the ER was in the past, prior to the vaccine. She says no one can figure out what it is. Some said it was anxiety, she sat through a whole program on anxiety and they decided not that is not what it is. But the fact that she hadn't had one of these episodes in 2 years and she had a good sized one 2 days after the vaccine, she had a really hard one that is why she thought she better report it. It has definitely gotten better she still feels jittery and heat flush every once in a while, but her blood pressure is fine. It is 139/74 and pulse 74. She can tell its still there but improved and certainly not uncomfortable. The events did not require a visit to the emergency room or the physician's office but she contacted her doctor's office and she has an online thing with them in a half an hour from the time of the report. The outcome of the event crazy blood pressure fluctuations the highest was 188/89/bp was around 159 or 150 then it came down to 136/71 and heart pounding/highest pulse was 106 was recovering while the outcome of the events feeling real jittery and hot flush feeling like an adrenaline rush in her upper chest and arms was unknown.; Sender's Comments: Based on temporal association, the contribution of the suspect drug to the onset of event  blood pressure fluctuation cannot be excluded. The cardiovascular medical history is likewise a risk factor.  The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to RAs, Ethics Committees, and Investigators, as appropriate.