burning sensation; pain in shoulder radiating down are and up to neck; pain in shoulder radiating down are and up to neck; altered sensation but no numbness; reduced power (should abduction and shoulder anterior flexion); nerve pain; off label use; interchange of vaccine products; this is a spontaneous report received from a contactable reporter (physician) from the regulatory agency (ra). regulatory number: gb-mhra-webcovid-202202151228421410-32owk (ra). other case identifier: gb-mhra-adr 26606993 (ra). a female patient received bnt162b2 (comirnaty), administration date 25dec2021 (batch/lot number: unknown) as dose 3 (booster), single for covid-19 immunization. relevant medical history included: "diabetes mellitus type 2" (unspecified if ongoing), notes: diabetes mellitus, type 2, well controlled hypothyroidism and "hypothyroidism" (unspecified if ongoing), notes: diabetes mellitus, type 2, well controlled hypothyroidism. the patient's concomitant medications were not reported. vaccination history included: chadox1 ncov-19 (dose number unknown, single), administration date: 27may2021 for covid-19 immunization and covid-19 vaccine (dose number unknown, manufacturer unknown) for covid-19 immunization. patient had not tested positive for covid-19 since having the vaccine. patient didn't had symptoms associated with covid-19. the patient doesn't had a covid-19 test. patient was not enrolled in a clinical trial. the following information was reported: off label use (disability) with onset 25dec2021, outcome "unknown", described as "off label use"; interchange of vaccine products (disability) with onset 25dec2021, outcome "unknown", described as "interchange of vaccine products"; burning sensation (disability), outcome "not recovered", described as "burning sensation"; neuralgia (disability) with onset 25dec2021, outcome "not recovered", described as "nerve pain"; arthralgia (disability), neck pain (disability), outcome "unknown" and all described as "pain in shoulder radiating down are and up to neck"; sensory disturbance (disability), outcome "unknown", described as "altered sensation but no numbness" and muscular weakness (disability), outcome "unknown", described as "reduced power (should abduction and shoulder anterior flexion)". it was reported that the patient had vaccine in late christmas, coded on emis as 25dec2021. after vaccination, the patient had pain in shoulder radiating down and up to neck. altered sensation but no numbness. burning sensation. reduced power (should abduction and shoulder anterior flexion). this report doesn't relate to possible myocarditis or pericarditis, blood clots or low platelet counts. the patient underwent the following laboratory tests and procedures: x-ray: unknown results, notes: awaiting review by msk triage team, also cervical xr. no follow-up attempts are possible; information about lot/batch number cannot be obtained. no further information is expected