spinal pain; feels like spinal inflammation; feeling nervous; lower back pain; This is a spontaneous report from a contactable consumer (patient) or other non hcp. A 41-years-old female patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot number: EW0164) via an unspecified route of administration, administered in left arm, on 22Apr2021 12:30 (at the age of 41 years), as dose 1, single for COVID-19 immunization. Medical history included ongoing tachycardia (diagnosed about 20 years ago). Concomitant medication included alprazolam (XANAX) (0.25 mg as needed once a month for about 6 months) taken for anxiety, start and stop date were not reported. The patient did not receive additional vaccines. The adverse event did not result in Physician office or Emergency room visit. The patient did not receive prior vaccination with in 4 weeks. The patient did not experience adverse event following prior vaccination. The patient experienced lower back pain at the base of her spine above the tailbone. The patient lower back pain is in the spinal area from the tailbone to the lower back. The patient lower back pain is very painful. The patient was wondering if anyone else experienced the same side effect of lower back pain. The patient stated her lower back pain started over the weekend. The patient stated she thinks that the back pain began on Saturday, 01May2021, but the back pain had for sure started by Sunday, 02May2021. The patient stated she thinks that her lower back pain began on the night of Saturday 01May2021. The patient stated, she had the COVID-19 vaccine on 22Apr2021. The patient stated it had been a week and a half since she had the COVID-19 vaccine when the lower back pain started. The patient stated, she went to the doctor last week and her physician checked her blood to see if she had antibodies for COVID-19. The patient stated, as of last week she had no antibodies. The patient stated, she was not having any lower back pain when she went to the doctor last week. The patient stated, she knows that the COVID-19 vaccine had not worked yet as of last week. The patient stated, maybe the COVID-19 vaccine started working in her body this weekend and that's why she started getting side effects. The patient stated, her lower back pain started out mild, just right in her tailbone in her spine. The patient stated the lower back pain is now radiating upwards in her spine towards her lower middle back. The patient stated the back pain is super centered. The patient stated the back pain is literally right in the middle of her spine just above the tailbone. The patient stated, the lower back pain feels like spinal inflammation. The patient stated the lower back pain is hard to describe. The patient stated the lower back pain is super sharp and severe. The patient stated, her physician said that she could go back again to get an antibody test drawn again to see if now the COVID-19 vaccine worked. The patient asked if she should get the second dose of the COVID-19 vaccine. The patient stated, she had no side effects following the COVID-19 vaccine. The patient stated, she could not even see that she had received an injection. The patient stated, she did not have any swelling or pain and really had nothing following the COVID-19 vaccine. The patient stated, she wondered to herself if she received the 6th dose of the COVID-19 vaccine and that's why her arm was not showing anything. The patient stated, she has underlying tachycardia, so she wanted to be extra safe. The patient stated, she did take a XANAX right before she got the COVID-19 vaccine. The patient stated, a doctor administered her vaccine. The patient stated, she informed the doctor that she was feeling nervous, and she was afraid that her nerves were going to trigger her tachycardia. The patient stated the physician that administered her COVID-19 vaccine instructed her to take a XANAX. The patient stated, she has an as needed heart medication. The patient stated, she asked the physician who administered her COVID-19 vaccine if the caller should take a dose of her beta blocker. The patient stated, the physician informed her to take a beta blocker if she needed to. The patient stated, she didn't know if she could take the XANAX or the beta blocker. The patient stated, she didn't want to take anything that could mess up her immune response to the COVID-19 vaccine. The patient inquired if she should go to immediate care for her lower back pain. The patient stated, she was probably going to go to immediate care for X-rays of her back. The patient stated, she wanted to speak to another agent to see if someone had some knowledge regarding her questions. The patient underwent lab tests and procedures which included SARS-CoV-2 antibody test: negative on 27Apr2021. The outcome of back pain was not recovered. The outcome of remaining events was unknown.   Follow-up attempts are needed. further information is expected.