tired out; confusion; primary immunisation: unknown manufacturer (at least one non-pfizer covid-19 vaccine); booster: comirnaty; primary immunisation: unknown manufacturer; (at least one non-pfizer covid-19 vaccine); booster: comirnaty; this is a spontaneous report received from a contactable reporter (consumer or other non hcp) from the medicines and healthcare products regulatory agency (uk-mhra). regulatory number: gb-mhra-webcovid-202202141915419340-9dj6m (mhra). other case identifier: gb-mhra-adr 26603313 (mhra). a 48-year-old female patient received bnt162b2 (comirnaty), administration date 16dec2021 (batch/lot number: unknown) as dose 3 (booster), single for covid-19 immunisation. the patient's relevant medical history and concomitant medications were not reported. the patient had no symptoms associated with covid-19 and not had a covid-19 test. the patient was not enrolled in clinical trial. vaccination history included: covid 19 vaccine (dose 1, manufacturer unknown), for covid-19 immunisation; covid 19 vaccine (dose 2, manufacturer unknown), for covid-19 immunisation. the following information was reported: off label use (medically significant) with onset 16dec2021, outcome "unknown", described as "primary immunisation: unknown manufacturer (at least one non-pfizer covid-19 vaccine); booster: comirnaty"; interchange of vaccine products (medically significant) with onset 16dec2021, outcome "unknown", described as "primary immunisation: unknown manufacturer; (at least one non-pfizer covid-19 vaccine); booster: comirnaty"; fatigue (medically significant) with onset 30dec2021, outcome "not recovered", described as "tired out"; confusional state (medically significant) with onset 29dec2021, outcome "not recovered", described as "confusion". the patient had not tested positive for covid-19 since having the vaccine. no follow-up attempts are possible; information about lot/batch number cannot be obtained. no further information is expected