tachycardia; panic attacks; pins and needles; anxiety; vertigo; off label use; interchange of vaccine products; tinnitus; 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-202202181011463080-9mx7z (ra). a 35 year-old patient received bnt162b2 (comirnaty), administration date 18dec2021 (lot number: fn3543) at the age of 35 years as dose 3 (booster), single for covid-19 immunisation. the patient's relevant medical history and concomitant medications were not reported. vaccination history included: covid-19 vaccine astrazeneca (dose 1, ), administration date: 29mar2021, for covid-19 vaccination; covid-19 vaccine astrazeneca (dose 2, ), administration date: 16jun2021, for covid-19 vaccination. the following information was reported: off label use (hospitalization, medically significant) with onset 18dec2021, outcome "unknown", described as "off label use"; interchange of vaccine products (hospitalization, medically significant) with onset 18dec2021, outcome "unknown", described as "interchange of vaccine products"; anxiety (hospitalization, medically significant) with onset 24dec2021, outcome "recovered with sequelae", described as "anxiety"; tachycardia (hospitalization, medically significant) with onset 25dec2021, outcome "recovering", described as "tachycardia"; panic attack (hospitalization, medically significant) with onset 25dec2021, outcome "recovering", described as "panic attacks"; paraesthesia (hospitalization, medically significant) with onset 24dec2021, outcome "recovered" (29dec2021), described as "pins and needles"; tinnitus (hospitalization, medically significant) with onset 18dec2021, outcome "not recovered", described as "tinnitus"; vertigo (hospitalization, medically significant) with onset 20dec2021, outcome "recovered with sequelae", described as "vertigo". the patient underwent the following laboratory tests and procedures: sars-cov-2 test: negative, notes: no - negative covid-19 test. additional information: patient has not had symptoms associated with covid-19. patient was not enrolled in clinical trial. no follow-up attempts are possible. no further information is expected