coughing; blood mucus; sore throat; fatigue; respiratory type symptoms; This is a spontaneous report received from contactable reporter(s) (Consumer or other non HCP) from medical information team. The reporter is the parent.  A 16 year-old female patient received bnt162b2 (BNT162B2), administered in arm, administration date 15May2021 (Lot number: ER8731) at the age of 16 years as dose 1, single for covid-19 immunisation. Relevant medical history included: "lymphadenopathy in her neck." (unspecified if ongoing), notes: The patient has had lymphadenopathy in her neck. There were no concomitant medications. The following information was reported: COUGH (non-serious) with onset 16May2021, outcome "recovered" (May2021), described as "coughing"; EPISTAXIS (non-serious) with onset 16May2021, outcome "recovered" (May2021), described as "blood mucus"; RESPIRATORY SYMPTOM (non-serious) with onset 2021, outcome "recovered" (2021), described as "respiratory type symptoms"; OROPHARYNGEAL PAIN (non-serious) with onset 16May2021, outcome "recovered" (May2021), described as "sore throat"; FATIGUE (non-serious) with onset 2021, outcome "unknown", described as "fatigue". The events "coughing", "blood mucus", "respiratory type symptoms" and "sore throat" were evaluated at the physician office visit. Relevant laboratory tests and procedures are available in the appropriate section.  Additional information: Per caller, their daughter received 2 doses of the Pfizer-BioNTech Covid19 Vaccine. 1st dose was last 15May2021 and 2nd dose was last 05Jun2021. After their daughter's 1st dose, she experienced respiratory symptoms such as, sore throat, coughing, blood mucus that lasted for few days and the she was fine. Weight (kg) was 51.71. Height (cm) was 157. The patient has lost 7 pounds. The patient was athletic but she was losing weight. After the first dose the patient had respiratory type symptoms and went to the pediatrics office on 17May2021. The patient had a sore throat, coughing and blood tinged mucus when she coughed. These symptoms lasted a few days then the patient was fine. The evening of 05Jun2021, the patient had fever, chills, body shake, headache, coughing, sore throat, and fatigue which all lasted longer than after the first dose. The patient was feeling fatigued pretty much all summer and the caller thought it was because the patient was working with her husband but now the caller was thinking its from the vaccine. On 21Aug2021 was when things started up again and hasn't gone away since. On 21Aug2021 the patient had a sore throat, congestion, and upper respiratory symptoms. The patient was tested for covid and strep as part of the rule out. The patient went to her pediatrician on 23Aug2021. 7 days later the patient wasn't improving and went back to the pediatrician because she was vomiting, had a headache, fatigue, and body aches going on. Since all of this started in August the caller doesn't know what symptoms will show up for the day in the patient. The patient has had fevers off and on, vomiting off and on. The patient has had swollen lymph nodes the whole time in her neck. The patient had a biopsy of the lymph nodes done. The doctors have ruled out a bunch of stuff but doesn't know what's going on with the patient but was thinking it s the vaccine. The patient also has swollen lymph nodes under her under arm and abdominal pain. The patient has had two different types of abdominal pain- one in the lower center of her abdomen which was more achey and then one in the upper left quadrant which was tender to touch and at times has stabbing pains there. The patient has headaches every day, most of the time its in the front but it has also been in the back of her head, its a throbbing and pounding pain. On a good day the patient's headache pain was 5/10 but on a bad day its 10/10. The caller has been tracking the patient's pain in her head, neck, and abdomen since 15Oct2021. Investigations included The patient has seen and ENT, rheumatologist, hematologist, infectious disease, and a neuro ophthalmologist. The patient has had CT scans- 2 of her neck and head and 2 of her abdomen. The second CT scan of the patient's abdomen was also and angio. The doctors were trying to rule out an abscess of the patient's tonsils. They did an MRI of the patient's head, neck, and brain to rule out tumors. They did an echo, EKG, ultrasound of the patient's abdomen, ultrasound of the patient's chest, a chest and neck x-ray. The patient has had blood work, every test you can think of they have run it on her. 80 tubes of blood has taken on the patient over the course of this time. The lab work showed that the patient's inflammation markers were elevated. The patient's C reactive protein was 2.1. The doctors were trying to figure out what was going on that doesn't fit into a category of anything particular. The patient's sedimentary rate was running high, her white blood cell count was high, CB19 cells were high, CD8T cells were high. The caller handed off the phone to the patient's father so that he could add to the report. Investigations included The patient's inflammatory markers have been elevated- platelets, C reactive proteins, sedimentary rate, RDW and everything that showed extreme inflammation has been elevated the whole time. The one phase the patient went through she had high white blood cell counts. None of the patient's labs have been sky high but they have been consistently elevated. The patient has had lymphadenopathy in her neck. The pain sensations in the patient's abdomen and lymph nodes, they haven't been able to pinpoint all of this. The doctor mentioned that they have seen a couple of patients with splenitis but that was not seen on the patient's CT scans. The patient had 2 Rash situations where she started running a fever and developed a rash, neck, and chest. At first the caller thought it was a reaction to the Azithromycin antibiotic that she took. The patient only took one tablet and the doctor told her to stop taking them. The patient hadn't had a rash until today where she spiked a fever last couple of days. The rash was from the patient's neck and everywhere. The patient was not currently on any medications. The immune mediated reaction was going on through the patient's body. The patient had a biopsy of the lymph nodes because they were afraid it was cancer. The biopsy showed CD4 and CD8 immunoglobulins had double negative receptors and the doctors were concerned about a particular helps but the patient was negative. Those markers were supposed to be about 10% and the patient's was at 6 % so they were checking that for awhile but it was negative. The patient's biopsy was negative for infection and cancer. Since this started, the patient has had a low grade but big immunological reaction.  No follow-up attempts are possible. No further information is expected.