I go all the way to the PET scan and PET scan is the one that detects cancer; I just now this February discovered that I have a lung nodule; This is a spontaneous report received from a contactable reporter(s) (Consumer or other non HCP) from medical information team The reporter is the patient.  A 71-year-old female patient received BNT162b2 (BNT162B2), as dose 1, single (Batch/Lot number: unknown), as dose 2, single (Batch/Lot number: unknown) and as dose 3 (booster), single (Batch/Lot number: unknown) for covid-19 immunisation. The patient's relevant medical history and concomitant medications were not reported. Past drug history included: Humira; Imitrex/sumatriptan for headache. The following information was reported: PULMONARY MASS (non-serious) with onset Feb2022, outcome "unknown", described as "I just now this February discovered that I have a lung nodule"; NEOPLASM MALIGNANT (medically significant), outcome "unknown", described as "I go all the way to the PET scan and PET scan is the one that detects cancer". Clinical course: "Caller (female DOB: withheld) taking Xeljanz Per agent: caller said: I am too tired, I am too fatigued the arthritis is awful caller stated I have been on Xelanz 4 years comes this June and in the laswt 8/9 or 10 months I have been feeling more  and more and more fatigued and of course arthritis is a progressive disease and it's never going to get better we just trying to stop it in it's track as much as we can. Before Xeljanz I was on Humira for like 8 years and I went to a new doctor and they thought that Pfizer Xeljanz might do better and I was liking that I didn't have to do shots. I am fully vaccinated with Pfizer Covid 19 vaccine and two boosters. Caller stated that she wanted to speak to Pfizer first before speaking to her doctor about potential discontinuation of Xeljanz, caller stated that she knows that all the medications have side effects but this time she decided to read  more about Xeljanz, she looked at Xeljanz information and noted side effects headache and diarrhea. Caller stated : I go to the bathroom in the morning 4-5 times I empty my bowels and they always loose then I have to check with my doctor I have been on Imitrex/Sumatriptan because I have this headaches that are over the top and another thing it just comes at night, pretty much at night during a day maybe a little throbbing but nothing that I cannot handle but the night is terrible not  every night comes and goes. So headache diarrhea and I am looking at the paper now under Xeljanz XR 11mg tablets unusual tiredness and that what prompted me to sit up and take notice, because I've been crying literally tears on my face to my arthritis doctor 8-9 months just under the year about all those symptoms and especially tiredness that she was suggesting to the doctor that she was having fibromyalgia, I am taking a medication and the pain is over the top in my joints and my muscles, I know it's a progressive disease but you would think that this pill would do something  she ( doctor) ordered a bone scan right away and she took it October last year, and that show that yes it is progressing and it is now in my feet, I am limping now on and off. Doctor said you could have a fibromyalgia as you are getting older and as it is progressing that's the thought about getting of the medication started formulating I never thought that the side effect for Xeljanz was unusual fatigue, Headache, diarrhea and even the rest of it which is bigger than unusual tiredness I don't have any loss of appetite I don't have stomach pains, no yellowing , no dark urine, no fast heart beat, it is just I can't I never sleep anymore, O am going to the sleep doctor I have a cpap thing, I am thinking to myself I am blaming everything on anything else  Could it be one pill that causing all of this? My inflammatory numbers are always fine. This pill keeping inflammatory at bay. I have been doing it every 3 months for 4 years because the side effects kill your liver and anything else, because I had a good numbers, I pushed it from 3 to 4 months and they allowed it. I have been going every 4 months for the blood I will go next time in August went last time in April so with this unusual tiredness and the fatigue and I am surprised that she did not mention that. She was researching and happen to look at the black box warning. Is the fatigue masking a fibromyalgia? This pill makes me fell like I just don't want to get out of bed in the morning. I can't get up and do my business and the stupid Xeljanz. I have as much a joint pain more more you know that I am saying? In 4 years, I am having such a joint pain and such a fatigue the only good thing that Pfizer pill is doing good for me for which I am thankful for is to keep my inflammation down. Why do I have all this pain and fatigue and the good numbers with inflammation? but is like killing me fatigue wise and moving I don't understand How can I equate a great inflammatory versus how I feel with the headache and loose stool but especially the  fatigue and intense headaches, how does the pill do one thing and then does the other so what is your educated medical advice ( explained that we are unable to provide any type of treatment recommendations and refer to HCP) Does the medicine usually do that? Can you explain that to me? How does it work?  If it's not helping my joint pain and I am in such a pain What is hurting? If those side effects are coming from the pill that maybe too much for me to bear. I don't understand what is causing a joint pain? What is giving me a pain Pfizer pill or progression of the disease? Caller stated that she understood that one patient may have done well on the medication and the other may not. Caller stated I have a Psoriatic arthritis this is my primary diagnosis with rheumatism Caller asking if considering her situation and side effects would be an option to discontinue the medication? As she is on the couch now (again refer to treating HCP) I force myself when I have to go and see a doctor and don't go out much as it is. My quality of life like everyone's that are older and having underling disease has gone the tubes since covid and I have already taken those two vaccines and those two boosters I took the last booster in April I cannot take all of this junk in my body anymore so could you just give me your best medical advice by listening to me? (Again refer to HCP explained that we are unable to provide any medical treatment recommendations) Is it stupid to get off Xeljanz just to see if it is Xeljanz that causing those symptoms? What is it mean black box warning? For me that means the worst you can get from the medication. I just now this February discovered that I have a lung nodule, on my right lung I go all the way to the PET scan and PET scan is the one that detects cancer and black box for this drug Xeljanz mentions death, cancer, especially in the lung and some other big things, caller stated that now the lung nodule is benign she is seeing pulmonologist, then she sated : I found out last month that I have a cyst in my thyroid that my arthritis doctor found and I am going to endocrinologist tomorrow. When I hear lungs cancer and now, I have a nodule and I am a former smoker get this medicine from me as far as possible then I was shocked about my thyroid having a cyst, what is doing this to me? is it my disease or the pill itself? You helped me I am very thrilled that I got so talk to someone who is educated and well versed as I did with you and will move on to make sure that I will speak to my doctor, I thank you from the bottom of my heart for giving me as much information as you can on this, thank you. Per general medical knowledge explained that black box warning is designed to call attention to serious or life-threatening risks but refer to the FDA for more more specific details pertaining to the black box warnings with the medication. Question: You helped me I am very thrilled that I got so talk to someone who is educated and well versed as I did with you and will move on to make sure that I will speak to my doctor, I thank you from the bottom of my heart for giving me as much information as you can on this, thank you." The information on the batch/lot number for BNT162b2 has been requested and will be submitted if and when received.