urticaria; developed a dermatological condition of her toes (covid toes, frost bite like) blue, red, swollen itchy and hot; developed a dermatological condition of her toes (covid toes, frost bite like) blue, red, swollen itchy and hot; developed a dermatological condition of her toes (covid toes, frost bite like) blue, red, swollen itchy and hot; developed a dermatological condition of her toes (covid toes, frost bite like) blue, red, swollen itchy and hot; Painful toes; also has a herpetic type sore on her facial nerve/ increase in cold sores; After the second dose came on as gang busters and was worsened/ She may have had mild symptoms after the first dose, but worsened after 2nd dose; do have a condition that resembles frost bite with actual disease; This is a spontaneous report from a contactable physician. A 44-years-old female patient received the first and second dose of bnt162b2 (BNT162B2, PFIZER-BIONTECH COVID-19 VACCINE, formulation: solution for injection, Batch/Lot number: Not reported), via an unspecified route of administration on an unspecified date both as single dose for COVID-19 immunization. The patient medical history and concomitant medications were not reported. On an unspecified date, patient experienced urticaria about a week after the 1st and 2nd immunization with Pfizer and most recently about a week or 2 weeks after the second dose of the covid vaccine, after the 1st dose patient with urticaria, after one week with mild response of toes after first dose, 2nd dose urticaria delayed one week, after the second dose came on as gang busters and was worsened, painful toes, can't put on her shoes, developed a dermatological condition of her toes (covid toes, frost bite like) blue, red, swollen itchy and hot, also has a herpetic type sore on her facial nerve/ increase in cold sores, after the second dose came on as gang busters and was worsened/ she may have had mild symptoms after the first dose, but worsened after 2nd dose, do have a condition that resembles frost bite with actual disease. Reporter mentioned that International data is available from (Continent name) - as a direct result of the virus (disease) instead of this it may be an indirect autoimmune response from the vaccine, they are studying it with a neurological agent It's very important, because if it is because of the vaccine vs virus then the approach to treatment would be quite different. Reporter also mentioned that patient hasn't had any signs and symptoms of virus, reporter looked it up on Up-to-date and mentioned that they do have a condition that resembled frost bite with actual disease, as an autoimmune response. Reporter also mentioned that certainly you can develop an immune response to the vaccine that can provoke this. Reporter wanted to know if any reports of this with the vaccine. Reporter mentioned that he also had noticed an increase in cold sores in individuals who received the covid vaccine. Some others have had herpetic infection breakout along the branch of the herpetic nerve and some other nurses have had this reaction as well. Reporter wanted to know if Pfizer had any delayed response like this after the 2nd dose and week after following the vaccine. Outcome of the events was unknown.  Information on the Lot/Batch number has been requested.  Follow-up attempts are completed. No further information is expected.