sleeplessness; immense discomfort; itching began on my back spreading within days to most of upper body; hives; off label use; interchange of vaccine products; this is a spontaneous report received from a contactable reporter(s) (consumer or other non hcp) from a regulatory authority. the reporter is the patient. regulatory number: gb-mhra-webcovid-202202152038533090-zsj1j. other case identifier(s): gb-mhra-adr 26620852. a 72 year-old female patient received bnt162b2 (comirnaty), administration date 18nov2021 (lot number: fk4913) as dose 3 (booster), single for covid-19 immunisation. the patient's relevant medical history was not reported. concomitant medication(s) included: histamine; omeprazole, start date: 24jan2022, stop date: 08feb2022; prednisolone taken for urticaria, start date: 24jan2022, stop date: 08feb2022. past drug history included: flu vaccine for influenza immunisation, reaction(s): "inflammation on sides of torso", notes: inflammation on sides of torso hours after flu vaccination; flu vaccine for influenza immunisation, reaction(s): "itching at nape of neck", notes: inflammation and itching at nape of neck which gp treated with fucibat cream. vaccination history included: covid-19 vaccine astrazeneca (dose 1; batch/lot number unknown), administration date: 30jan2021, for covid-19 vaccination; covid-19 vaccine astrazeneca (dose 2; batch/lot number unknown), administration date: 23apr2021, for covid-19 vaccination. the following information was reported: off label use (medically significant) with onset 18nov2021, outcome "unknown", described as "off label use"; interchange of vaccine products (medically significant) with onset 18nov2021, outcome "unknown", described as "interchange of vaccine products"; insomnia (medically significant), outcome "recovering", described as "sleeplessness"; urticaria (medically significant) with onset 29nov2021, outcome "not recovered", described as "hives"; discomfort (medically significant), outcome "unknown", described as "immense discomfort"; pruritus (medically significant), outcome "unknown", described as "itching began on my back spreading within days to most of upper body". therapeutic measures were taken as a result of insomnia, urticaria, discomfort. 1 - 2 weeks after covid booster rash and intense itching began on back spreading within days to most of upper body (not face), stomach chest and arms. caused immense discomfort and sleeplessness. gp treated with prednisolone (+omeprazole), fexofenadine hydrochloride and betnovate rd cream. symptoms stopped for a few days, then itching without rash restarted around rib cage, close to armpits, inside elbows, palm of left hand. itching less intense and more tolerable than before but still uncomfortable and irritating. no follow-up attempts are possible. no further information is expected