presyncope; fatigue; cardiac dysfunction; nausea; generalized joint pain; headache; myalgia; malaise; injection site pain; this is a spontaneous report received from a contactable reporter (consumer) from the regulatory authority. regulatory number: nl-lrb-00737803. a 72 year-old female patient received bnt162b2 (comirnaty), administration date 17dec2021 (lot number: 1f100ba) as dose 3 (booster), 0.3 ml single for covid-19 immunisation. relevant medical history included: "chronic lyme" (unspecified if ongoing), notes: confounding factors. the patient's concomitant medications were not reported. vaccination history included: comirnaty (1st single dose at 0.3 ml), administration date: 25apr2021, for covid-19 immunisation, reaction(s): "flu"; comirnaty (2nd single dose at 0.3 ml), administration date: 30may2021, for covid-19 immunisation, reaction(s): "flu". the following information was reported: cardiac dysfunction (medically significant) with onset 20dec2021, outcome "recovering", described as "cardiac dysfunction"; nausea (non-serious) with onset 18dec2021, outcome "recovering", described as "nausea"; arthralgia (non-serious) with onset 18dec2021, outcome "recovered" (19dec2021), described as "generalized joint pain"; headache (non-serious) with onset 18dec2021, outcome "recovering", described as "headache"; presyncope (non-serious) with onset 24dec2021, outcome "not recovered", described as "presyncope"; fatigue (non-serious) with onset 24dec2021, outcome "not recovered", described as "fatigue"; myalgia (non-serious) with onset 18dec2021, outcome "recovered" (19dec2021), described as "myalgia"; malaise (non-serious) with onset 18dec2021, outcome "not recovered", described as "malaise"; vaccination site pain (non-serious) with onset 18dec2021, outcome "recovered" (18dec2021), described as "injection site pain". the patient underwent the following laboratory tests and procedures: blood test: unknown results; electrocardiogram: unknown results; pulmonary imaging procedure: unknown results. no follow-up attempts are possible. no further information is expected