The second dose in 1/07 caused him to have a severe PFAPA episode; His tonsils were really swollen just like in a PFAPA episode but more than usual; His lymph nodes were extremely swollen; He complained about neck pains for days; He had fevers as high as 103.7 that did not respond to Tylenol; This is a spontaneous report from a contactable reporter (consumer or other non-HCP). The reporter is the parent.   A 6-year-old male patient received bnt162b2 (BNT162B2), administered in right arm, administration date 07Jan2022 (Lot number: FL0007) at the age of 6 years as dose 2 (tris), single for COVID-19 immunisation. Relevant medical history included: "PFAPA syndrome" (Periodic fever, aphthous stomatitis, pharyngitis and adenitis) (unspecified if ongoing), notes: PFAPA. Concomitant medications included: unspecified MULTI VITAMINS. Vaccination history included: Bnt162b2 (DOSE 1 (TRIS), SINGLE, Lot number: FK5127, Anatomical site: Right arm), administration date: 08Dec2021, when the patient was 6 years old, for COVID-19 immunisation.  The following information was reported: CONDITION AGGRAVATED (non-serious) with onset 07Jan2022, outcome "unknown", described as "The second dose in 1/07 caused him to have a severe PFAPA episode"; TONSILLAR HYPERTROPHY (non-serious) with onset 07Jan2022, outcome "unknown", described as "His tonsils were really swollen just like in a PFAPA episode but more than usual"; LYMPHADENOPATHY (non-serious) with onset 07Jan2022, outcome "unknown", described as "His lymph nodes were extremely swollen"; NECK PAIN (non-serious) with onset 07Jan2022, outcome "unknown", described as "He complained about neck pains for days"; PYREXIA (non-serious) with onset 07Jan2022, outcome "unknown", described as "He had fevers as high as 103.7 that did not respond to Tylenol". The events "The second dose in 1/07 caused him to have a severe PFAPA episode", "His tonsils were really swollen just like in a PFAPA episode but more than usual", "His lymph nodes were extremely swollen", "He complained about neck pains for days" and "He had fevers as high as 103.7 that did not respond to Tylenol" were evaluated at the physician office visit. Relevant laboratory tests and procedures are available in the appropriate section. Therapeutic measures were taken as a result of condition aggravated, tonsillar hypertrophy, lymphadenopathy, neck pain and pyrexia.  Additional information: The patient had no known allergies. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. It was reported that the reporter's son had PFAPA and consulted his infectious disease specialist before getting him vaccinated. They recommended him to get the vaccine. He took the first dose just fine. The parent took him to the doctor on 11Jan2022. The nurse practitioner tested him for the flu and COVID which both returned negative. The tests were just as a precaution but with his PFAPA history they knew that's most likely what it was. Nurse advised to try MOTRIN to reduce the fevers, it helped but fevers wouldn't go down completely. Fevers lasted 6 days. The patient had another episode that is lasting longer than what they normally would and his tonsils were staying swollen longer than usual. Treatment included TYLENOL for pyrexia and MOTRIN for condition aggravated, tonsillar hypertrophy, lymphadenopathy, neck pain and pyrexia. Since the vaccination, the patient had been tested for COVID-19.