booster; swollen eyes; facial swelling; oxygen saturation decreased; body temperature increased; skin reaction; off label use; interchange of vaccine products; coughing; this is a spontaneous report received from a contactable reporter(s) (consumer or other non hcp) from the regulatory authority. regulatory number: gb-mhra-webcovid-202202100521425250-3vtlq. other case identifier(s): gb-mhra-adr 26585785. a 46 year-old female patient (not pregnant) received bnt162b2 (comirnaty), administration date 25jan2022 (lot number: fn3543) at the age of 46 years as dose 3(booster), single for covid-19 immunisation. relevant medical history included: "anaphylactic reaction" (unspecified if ongoing); "eczema" (unspecified if ongoing); "asthma" (unspecified if ongoing); "steroid therapy" (unspecified if ongoing), notes: taking regular steroid treatment (e.g. orally or rectally); "prophylaxis" (unspecified if ongoing); "depression" (unspecified if ongoing); "multiple allergies" (unspecified if ongoing); "pain" (unspecified if ongoing); considered cev. concomitant medication(s) included: azithromycin taken for prophylaxis; betamethasone taken for eczema; braltus taken for asthma; citalopram taken for depression; epipen; fexofenadine taken for multiple allergies; hydrocortisone taken for eczema; ibuprofen taken for pain; montelukast taken for asthma; paracetamol taken for pain; seretide taken for asthma; uniphyllin taken for asthma; ventolin [salbutamol sulfate] taken for asthma; vitamin k komplex. vaccination history included: covid-19 vaccine astrazeneca (dose 1, batch no: pv46664), administration date: 04mar2021, for covid-19 immunization; covid-19 vaccine astrazeneca (dose 2, batch no: pw40041), administration date: 22may2021, for covid-19 immunization. the following information was reported: off label use (disability, medically significant) with onset 25jan2022, outcome "unknown", described as "off label use"; interchange of vaccine products (disability, medically significant) with onset 25jan2022, outcome "unknown", described as "interchange of vaccine products"; immunisation (disability, medically significant), outcome "unknown", described as "booster"; eye swelling (disability, medically significant), outcome "recovering", described as "swollen eyes"; swelling face (disability, medically significant), outcome "recovering", described as "facial swelling"; cough (disability, medically significant) with onset 25jan2022, outcome "recovered", described as "coughing" (within a minute of the injection being administered she began coughing, unstoppably. the coughing carried on for 3 hours. sats dropped to 90/91. inhaler and water no help. same reaction happened with both az injections too although the first reaction was about 5 mins before it started ( lasted 6/7 hours) and second was almost instant as pfizer ( lasted 4 hours,)); oxygen saturation decreased (disability, medically significant), outcome "recovering", described as "oxygen saturation decreased"; body temperature increased (disability, medically significant), outcome "recovering", described as "body temperature increased"; skin reaction (disability, medically significant), outcome "recovering", described as "skin reaction" (started after 10-15 mins and 3 hours to be able to see properly). the patient underwent the following laboratory tests and procedures: oxygen saturation decreased: dropped to 90/91; sars-cov-2 test: negative, notes: no - negative covid-19 test. therapeutic measures were taken as a result of oxygen saturation decreased. patient has not had symptoms associated with covid-19. patient is not enrolled in clinical trial. no follow-up attempts are possible. no further information is expected