tired; nauseous; headache; her arm was sore; This is a spontaneous report from a contactable consumer (patient) and from a Pfizer-sponsored program COVAX  Support.  A 58-years-old female patient received the second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE Batch/Lot number was not reported), via an unspecified route of administration on 23Feb2021 around 12:20-12:30 (at 58 years old) as single dose for covid-19 immunisation. Medical history included ongoing atrial fibrillation, anxiety, underactive thyroid and cholesterol. Concomitant medications included paracetamol (TYLENOL EXTRA STRENGTH), via an unspecified route of administration on 23Feb2021 (Batch/Lot number Other: DAE30 could be an O 37A; Expiration Date: Aug2021, NDC number of Top Care Extra Strength Tylenol: 36800-484-71) at 1000mg, 2 caplets for headache and magnesium for atrial fibrillation. She does take other medicines, because she was in atrial fibrillation, she took extra of her atrial fibrillation medications. She also took magnesium. She took that every day anyway but sometimes she takes an extra pill or 2 to help go back to sinus rhythm if she was in atrial fibrillation. The patient also had an underactive thyroid. She took a very low dose medicine for cholesterol only 10 mg. The patient received the first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE Batch/lot number: EN6198) intramuscular injection, left arm on 29Jan2021 (at 58 years old) and experienced atrial fibrillation and headache. The patient previously received the second dose of the varicella zoster vaccine. Illness at vaccination included atrial fibrillation and headache. Before getting the vaccine on 23Feb2021 she had a bad headache, and so she took 2 extra strength Tylenol a couple of hours before receiving the 2nd dose of the vaccine. The patient experienced tired, nauseous, headache, her arm was sore on 23Feb2021. The patient recovered from tired, nauseous, headache on 24Feb2021, from arm sore on 26Feb2021. The events did not require an emergency room visit nor a physician office visit. The clinical course was reported as follows. The patient was in distress over this, she can't sleep or eat, experiences anxiety anyway but now she's worried that she's not as protected because she took the Tylenol before the second dose of the vaccine. The patient reported that on 22Feb2021 at 10PM her atrial fibrillation started. The atrial fibrillation was still going on when she went to get the dose, when she got the dose, and even after she got the dose. The atrial fibrillation didn't go away until that evening, 23Feb2021 around 5-6pm. Then she went back to sinus rhythm. After she got home from getting the Covid 19 vaccine she took a shower she didn't feel good. She was tired but she didn't sleep the night before because she was in atrial fibrillation and was exhausted. Because she didn't sleep much she doesn't know if the tiredness was from the vaccine or atrial fibrillation. She reported an headache but she stated she may have had a headache before because she got headaches and took Tylenol, but thought she had after too. She ate breakfast then she didn't eat until dinner time and she felt nauseous. She felt more nauseous, she didn't throw up and she took Tylenol again that evening on the 23Feb2021. When she woke the next day on 24Feb2021 she got nauseous again but after the second day she didn't have nausea anymore. She wasn't sure if the nausea was from the vaccine. She's not positive. She just felt under the weather, but no fever or anything. She's a very anxious person and very worried. She reports her arm was sore, did not see any swelling or anything for 2 or 3 days. She feels pretty good today, back to normal.   Information on the lot/ batch number has been requested.