Immune-Mediated Small Fiber Neuropathy; I started to have vision issues initially, photophobia; double triple quadruple vision.; paresthesia's; head to toe neuropathy; burning (cold/hot burning) chest burning; difficulty swallowing; low urine flow; dysautonomia; not sweating properly; This is a spontaneous report received from a contactable reporter(s) (Nurse). The reporter is the patient.  A 38-year-old female patient (not pregnant) received BNT162b2 (BNT162B2), on 07Sep2021 as dose 3 (booster), single (Lot number: EW0217) at the age of 38 years intramuscular for covid-19 immunisation. The patient's relevant medical history included: "Rheumatoid Arthritis" (unspecified if ongoing), notes: on multiple medications; "asthma" (unspecified if ongoing); "allergies" (unspecified if ongoing); "hypothyroid" (unspecified if ongoing). The patient took concomitant medications. Vaccination history included: BNT162b2 (Dose Number: 2, Batch/Lot No: EN9581, Route of Administration: Intramuscular), administration date: 09Feb2021, when the patient was 37-year-old, for Covid-19 immunization; BNT162b2 (Dose Number: 1, Batch/Lot No: EK9231, Route of Administration: Intramuscular), administration date: 14Jan2021, when the patient was 37-year-old, for Covid-19 immunization. The following information was reported: PHOTOPHOBIA (disability) with onset 05Mar2022, outcome "not recovered", described as "I started to have vision issues initially, photophobia"; CHEST PAIN (disability) with onset 05Mar2022, outcome "not recovered", described as "burning (cold/hot burning) chest burning"; DYSPHAGIA (disability) with onset 05Mar2022, outcome "not recovered", described as "difficulty swallowing"; VISUAL IMPAIRMENT (disability) with onset 05Mar2022, outcome "not recovered", described as "double triple quadruple vision."; AUTONOMIC NERVOUS SYSTEM IMBALANCE (disability) with onset 05Mar2022, outcome "not recovered", described as "dysautonomia"; NEUROPATHY PERIPHERAL (disability, medically significant) with onset 05Mar2022, outcome "not recovered", described as "head to toe neuropathy"; URINE FLOW DECREASED (disability) with onset 05Mar2022, outcome "not recovered", described as "low urine flow"; HYPERHIDROSIS (disability) with onset 05Mar2022, outcome "not recovered", described as "not sweating properly"; PARAESTHESIA (disability) with onset 05Mar2022, outcome "not recovered", described as "paresthesia's"; SMALL FIBRE NEUROPATHY (disability) with onset May2022, outcome "not recovered", described as "Immune-Mediated Small Fiber Neuropathy". The events "i started to have vision issues initially, photophobia", "double triple quadruple vision.", "paresthesia's", "head to toe neuropathy", "burning (cold/hot burning) chest burning", "difficulty swallowing", "low urine flow", "dysautonomia", "not sweating properly" and "immune-mediated small fiber neuropathy" required physician office visit. The patient underwent the following laboratory tests and procedures: Biopsy skin: (May2022) Immune-Mediated Small Fiber; SARS-CoV-2 test: (Oct2022) Positive, notes: Nasal Swab. Therapeutic measures were taken as a result of photophobia, visual impairment, paraesthesia, neuropathy peripheral, chest pain, dysphagia, urine flow decreased, autonomic nervous system imbalance, hyperhidrosis, small fibre neuropathy.  Clinical course: no other vaccine in four weeks. Several other medications in two weeks as patient had Rheumatoid Arthritis and am on multiple medications. Patient started to have vision issues initially, photophobia, double triple quadruple vision. Thought it was related to inflammation from RA, or Sjogrens disease. Blew it off. Started with paresthesias in Mar2022, by the end of Mar head to toe neuropathy, burning (cold/hot burning) chest burning, difficulty swallowing, low urine flow, dysautonomia, not sweating properly. Diagnosed with Immune-Mediated Small Fiber Neuropathy in May2022 by skin punch biopsy. AE treatment included once diagnosed treatment included weekly Immunoglobulin therapy, lyrica, amitriptyline. No Covid prior vaccination. Patient was not tested for CIVID post vaccination. No known allergies.; Sender's Comments: Based on temporal association, there is reasonable possibility of causal association between the Reported events and the suspect drug. The impact of this report on the benefit/risk profile of the Pfizer drug 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 Regulatory Authorities, Ethics Committees, and Investigators, as appropriate.,Linked Report(s) : US-PFIZER INC-202201359155 Same reporter/patient, same drug/different dose, different AEs;