extremely ill; extreme fatigue; nausea; muscle aches; He is afraid she has COVID; have achy arm; This is a spontaneous report from a contactable consumer (patient reported herself). A 84-Year-old female patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, Batch/lot number: EL3949, NDC number: Unknown, Expiry Date: May2021) intramuscularly given very high in the top of left arm on 04Feb2021 9:20 AM at 0.3 ml single dose for Covid-19 immunization. The patient's medical history included fractured skull (five years ago), shingles (two years ago) and bleeding ulcers. Concomitant medications were not reported. Patient had the first dose of PFIZER-BIONTECH COVID-19 VACCINE last 04Feb2021 at 9:20 AM - Same day 6:00 PM started to have achy arm - After a few days developed symptoms like extremely ill, extreme fatigue, nausea, muscle aches. DSU potential duplicate AE Report E transmit - According to the patient she had already reported the side effects and transferred to our department. On 04Feb2021, the patient experienced arm started to ache like hell. Tiredness, muscle pain, nausea and feeling horribly ill. It was reported that, "she was having some symptoms. She got her vaccination on the 04Feb2021 and developed the symptoms yesterday. Her doctor was very alarmed that it was not just usual symptoms that go along with the vaccine because of the length of time between when she got it and when she developed symptoms. He was afraid she had COVID. She needed to know if that was normal so she could get back to him. Caller clarified that she meant side effects. She wanted to know whether it was normal to have gotten the vaccine on 04Feb2021 and not develop side effects until 09Feb2021. The vaccination was given in the morning at 9:20 AM and she did not have any symptoms until 6:00 PM that evening. Her arm started to ache like hell. That one showed up then, but cleared up in a couple of days. The arm got better and better. The other set of side effects started yesterday which was tiredness, muscle pain, nausea, and feeling horribly ill. She felt awful and did not want to go to a hospital if it was not necessary. HCP information included she had only seen him a couple of times. She had a long term doctor that retired and she got shifted over to him. They did not have a good relationship she must say. His whole group was associated with where she got the vaccine. They were all virtual now. She had been on lock down for a year. She did not have the doctor's address, phone number, or email. Tiredness, muscle pain, nausea, and feeling horribly ill: started yesterday morning when she got up between 4:30 AM and 5:00 AM. She was so woozy and thought it was left over sleep. She felt unwell all day. She had felt unwell today, but not as bad as yesterday. She had to get vaccination card out of hand bag and needs her glasses to read the small numbers. First dose was given on 04Feb2021. She had appointment on 25Feb2021 for second dose. Healthcare Provider who gave the vaccine was Hospital. They called her on the third at 5:00 PM to see if she could come the next day for the vaccine. They did a good job. Her brother was a retired anesthesiology and she called him this morning and he said to go to the hospital or testing center. Then he agreed that she should call Pfizer. History of all previous immunization with the Pfizer vaccine considered as suspect and additional vaccines administered on same date of the Pfizer suspect were none. She did not get her flu shot in anticipation of getting the COVID vaccine. Her brother and his granddaughter were both anesthesiologist. They get work up about not being able to breathe and ventilators. They gave advice. She was glad her brother approved for her to call Pfizer to find out. She wanted to believe it was side effects. She had been on lock down. Her brother said she could have been exposed at the vaccine site. Caller stated everyone had on a mask. She was not obese. She was not sure if it is relevant, but she would tell it anyway. She fractured her skull 5 years ago and was in Hospital because it was bleeding. That had resolved. She was in ICU and then six weeks of acute rehab. She had a bad case of shingles two years ago which led to bleeding ulcers. Again she went to the hospital, but she was scoped they found ulcers and treated. She went back for scope again and it had all healed up". Outcome of the event have achy arm was recovering whereas other events was unknown.