having tiredness after both the first and second dose of Pfizer's COVID vaccine; elevated plasma cell level; cancer indicator that is usually slightly elevated from his bone marrow aspirate; This is a spontaneous report from a contactable Pharmacist (patient). A 77-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot number: EL3249 and Expiration date not reported), via unknown route of administration in upper arm, on 13Jan2021 at 13:30, (at the age of 77 years) as a 1ST DOSE, SINGLE DOSE for COVID-19 immunization. The patient also received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot number: 19267 and Expiration date not reported), via unknown route of administration, in upper arm on 03Feb2021, at around 14:00, (at the age of 77 years) as a Second DOSE, SINGLE DOSE for COVID-19 immunization. The patient did not receive any other vaccines within four weeks prior to the vaccination. The patient medical history included heart bypass surgery (around 2015 or 2016), high blood pressure (probably around 2013), multiple myeloma (late 2006) and heart problems. The patient concomitant medications included acetylsalicylic acid (ASPIRINE), clopidogrel bisulfate (PLAVIX), olmesartan medoxomil (BENICAR), lenalidomide (REVLIMID) and zoledronic acid (ZOMETA). The patient states he started the ZOMETA medication after a stem cell transplant, around 2007, and then they did a bone density scan, and started the medication to increase bone strength. On an unspecified date the patient experienced, the patient had tiredness that's not normal for him after both the first and second dose of Pfizer's COVID vaccine (the last dose was in February). Patient staterd it's been a couple months now and he still feels tired. Patient was asking if that has been reported and how frequently and this has gone on for him for a few weeks. Patient had to do extensive blood work every 2 months all of my blood work is normal. He is not anaemic. Everything is normal. Blood oxygen, blood pressure, all of that's normal. Patient's heart rate may be a little bit low because of the medications he took. BP: 118/65 and heart rate in mid-60's. He doesn't know if the vaccine is reacting with Revlimid, but the doctor gave me the ok to get the vaccine. Patient was fatigued with the first vaccine and it went away before the second vaccine. On 03Feb2021, he had his second dose of vaccine, and he feels very fatigued lately. Patient reports he is feeling tired, and very fatigued, which is unusual for him. He reports that his is extremely active, and he is tired lately. He states that he has bloodwork and a urinalysis taken recently for his cancer, and his cardiologist has done tests. he reported that all the blood work is normal, and his cancer markers are steady and normal. he asks if this fatigue is a temporary side effect of the vaccine, and if it has been reported. he reports that he is tired mid-day, and he feels like he wants to lay down and take a nap. He states his primary care doctor will have access on the computer to his other doctors' information. He states he had called Pfizer about a week after he had the first vaccine, and spoke with an agent, that said his symptoms would go away. He states they had a conversation, and he was a Pharmacist. He states that he did not report his event or have a reference number. Fatigue, and feeling tired, ended about 2 or 3 days before the second vaccine and he was recovered enough that he had no concern about taking the second vaccine. He states he had this event, with both vaccines. After second vaccine he does not have a timeframe for the event (fatigue) because he wasn't sure if it was related to the vaccine, and not sure when it started (after lunch), as it has stayed the same and hasn't gotten better or worse. He was scared and his wife, is not as healthy, as he is, his wife has serious lung complications and he didn't want to bring the virus home to her, he was out in public, and shopping, in the pandemic. Reclarified, and explained the precautions he took while he was out of the house to be safe. Patient reported that his medication infusion requires bloodwork, which includes a CMP and CBC every 2 months on a routine basis, every two months he also sends in samples of blood and urine to be analyzed, he has a follow up doctor visit every 6 months, he is part of a research program, at the (name not provided), reports as all of those extensive analysis as normal, nothing is abnormal except the residual from his multiple myeloma, reports there is only one cancer indicator that is usually slightly elevated from his bone marrow aspirate and as an elevated plasma cell level. The patient underwent lab tests and procedures which included BP: 118/65 and heart rate in mid-60's, Blood oxygen was normal, blood tests normal, elevated plasma cells, urine analysis was normal. The outcome of the events was unknown.  Follow-up (28May2021): This is a follow-up spontaneous report from a contactable Pharmacist. Updated New information includes concomitant medications, patient history, vaccination dates, age, investigations, patient demographics.  Follow up needed, further information has been requested.