congested chest; headache; runny nose; chesty cough; off label use; interchange of vaccine products; this is a spontaneous report received from contactable reporter(s) (consumer or other non hcp). the reporter is the patient. a 50 year-old female patient (not pregnant) received bnt162b2 (comirnaty), administered in arm left, administration date 31jan2022 19:00 (batch/lot number: unknown) at the age of 50 years as dose 3 (booster), single for covid-19 immunisation. relevant medical history included: "pancreatitis chronic" (unspecified if ongoing). the patient's concomitant medications were not reported. vaccination history included: astrazeneca (dose: 2, batch/lot no: unknown. unable to locate or read the details, location of injection: arm left, vaccine administration time: 04:00 pm), administration date: 04jun2021, for covid-19 immunisation; astrazenecca (dose: 1, batch/lot no: unknown. not available/provided to reporter at the time of report completion, location of injection: arm left, vaccine administration time: 02:00 pm), administration date: 15mar2021, for covid-19 immunisation. the following information was reported: off label use (medically significant) with onset 31jan2022 19:00, outcome "unknown", described as "off label use"; interchange of vaccine products (medically significant) with onset 31jan2022 19:00, outcome "unknown", described as "interchange of vaccine products"; pulmonary congestion (medically significant) with onset 02feb2022 12:00, outcome "not recovered", described as "congested chest"; headache (non-serious) with onset 02feb2022 12:00, outcome "not recovered", described as "headache"; rhinorrhoea (non-serious) with onset 02feb2022 12:00, outcome "not recovered", described as "runny nose"; cough (non-serious) with onset 02feb2022 12:00, outcome "not recovered", described as "chesty cough". the patient underwent the following laboratory tests and procedures: sars-cov-2 test: (26dec2021) positive, notes: nasal swab. therapeutic measures were not taken as a result of pulmonary congestion, headache, rhinorrhoea, cough. clinical course: the patient was diagnosed with covid 19 prior to vaccination and since the vaccination patient has tested for covid 19. device date:18feb2022. the lot number for bnt162b2 was not provided and will be requested during follow up