difficulty in breathing; almost had a coma; progressive respiratory failure; progressive weakness in muscles; This is a spontaneous report received from contactable reporter(s) (Consumer or other non HCP) from medical information team.  A male patient received BNT162b2, BNT162b2 omi ba.4-5 (BNT162B2, BNT162B2 OMI BA.4-5), on 26Sep2022 as dose 4 (booster), single (Batch/Lot number: unknown) for covid-19 immunisation. The patient had no relevant medical history. The patient's concomitant medications were not reported. Vaccination history included: Covid-19 vaccine (DOSE 1; MANUFACTURER UNKNOWN), for COVID-19 Immunization; Covid-19 vaccine (DOSE 2; MANUFACTURER UNKNOWN), for Covid-19 immunization; Covid-19 vaccine (DOSE 3 (BOOSTER); MANUFACTURER UNKNOWN), for Covid-19 immunization. The following information was reported: DYSPNOEA (hospitalization, life threatening), outcome "unknown", described as "difficulty in breathing"; COMA (hospitalization, life threatening), outcome "unknown", described as "almost had a coma"; RESPIRATORY FAILURE (medically significant, life threatening), outcome "unknown", described as "progressive respiratory failure"; MUSCULAR WEAKNESS (non-serious), outcome "unknown", described as "progressive weakness in muscles". The events "difficulty in breathing", "almost had a coma" and "progressive respiratory failure" required physician office visit. The patient underwent the following laboratory tests and procedures: Computerised tomogram head: Nothing abnormal was found; Computerised tomogram spine: Nothing abnormal was found; Computerised tomogram thorax: Nothing abnormal was found; Electrocardiogram: Nothing abnormal was found; Magnetic resonance imaging: Nothing abnormal was found; Ultrasound scan: Nothing abnormal was found. Therapeutic measures were taken as a result of dyspnoea, coma, respiratory failure. The patient and the patient's wife lived in (Withheld) from 14Dec2013 to 27Mar2023. They had no health issue, never had to see a doctor, nor purchased health insurance. They were in good health. Unfortunately, the patient started to show progressive weakness in muscles and specific difficulty in breathing since 4th dose of Pfizer BioNTech COVID vaccine on 26Sep2022. During our flight back to (Withheld) from (Withheld), the patient showed significant difficulty in breathing and almost had a coma. They had to pause their trip at transitional flight airport of (Withheld). The patient was sent by the airport medical staff to ICU of (Withheld) in (Withheld). Doctors of (Withheld) performed CT Pulmonary scan, CT cervical spine scan, CT brain scan, ultrasound for legs, ECG and MRI. Nothing abnormal was found. The only problem was the difficult for breathing. The patient was now heavily relying on BiPAP ventilator. The patient was in good health and active before. He exercised everyday. He took walks for an hour each day and worked in a small vegetable garden in the back yard. Longevity was common in his family. His mother lived to 96. His two uncles live to nearly 100. The patient never had any physical injury. Therefore, all these had proved the Pfizer BioNTech COVID vaccine shot caused his breathing failure. The patient was among the few that had serious side effects from the shot. The patient's life was in grave danger. The progressive respiratory failure would cause him his life.  The information on the batch/lot number for BNT162b2, BNT162b2 omi ba.4-5 has been requested and will be submitted if and when received.