developed swelling and redness of both hands; developed swelling and redness of both hands; the left side (side which I got the shot) swelling was also in the feet, under the big toe and also in the right.; she felt pain in her left arm; But my forearm rash left hand to right forearm; rash fading this afternoon, warm to touch and swelling. The discoloration went from dark red to more like lighter red; You can feel the warmth; I also got the muscle aches; localized swelling and pain at injection site.; localized swelling and pain at injection site.; felt a little dizzy but that went away after the 30 minutes; throbbing at the injection site that is only a little pain today but no more throbbing; Adds she also got a muscular or nerve like pain in her neck and down the left side of her back.; Adds she also got a muscular or nerve like pain in her neck and down the left side of her back.; This is a spontaneous report from a contactable other healthcare professional (nurse, patient). A 65-year-old female patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, lot number: EP6955), via an unspecified route of administration, administered in left arm on 22Mar2021 09:20 (at the age of 65 years) as dose 1, single for COVID-19 immunization. The patients medical history included lupus (autoimmune disease) from 2010, gout and reacted severely to the shingles vaccine (Shingrix) in Sep and was sick for 3 weeks almost having shingles and like lupus my whole back was red and along the nerve pain and joint pain. Concomitant medications included allopurinol (ALLOPURINOL, 200mg) for gout taken one daily by mouth from Jan2020 and ongoing; levothyroxine sodium (SYNTHROID, 25mcg) for hypothyroidism take once daily by mouth from Mar2020 and ongoing; metoprolol (METOPROLOL, 25mg) for blood pressure taken one half once daily by mouth from Nov2020. The patient previously took plaquenil and developed toxicity about 3 years ago. She took it for 8 years and then she lost her central vision as a result of the toxicity. Before taking metoprolol she used to take Inderal 60mg for blood pressure. History of all previous immunization with the Pfizer vaccine considered as suspect were none. Additional Vaccines Administered on Same Date of the Pfizer Suspect were none. Prior Vaccinations (within 4 weeks) were none. On 22Mar2021 after vaccination patient waited for 30 minutes, felt a little dizzy but that went away after the 30 minutes then she went home. Adds she felt pain in her left arm, throbbing at the injection site that is only a little pain today but no more throbbing. She also got the muscle aches, localized swelling and pain at injection site. She did take Tylenol for the throbbing. Adds she also got a muscular or nerve like pain in her neck and down the left side of her back. That afternoon she noticed swelling in her hands and feet and the skin on her hands and feet was red like it was burned. The left side (side where she got the shot) swelling was also in the feet/ feet red, under the big toe and in the right. At first she thought it was topical but realized she hadn't used anything at the vaccination site. She had not used anything at the hospital on her hands so she knew it was not a topical rash. But my forearm rash left hand to right forearm; Adds she had a light rash up her left forearm that is slowly disappearing this afternoon, warm to touch and swelling. She took pictures of her hand to see the extend of the swelling and the rash. On 23Mar2021 (this morning) the swelling and redness in both feet is gone. Adds the left hand and left foot had more swelling and redness. Also the swelling and redness in her hands is still there but it is getting lighter and going down. The discoloration went from dark red to more like lighter red. It was so swollen the skin on top of her hand, it was shinny couldn't see my knuckles. You can feel the warmth. She was not sick enough to go to the doctor's office. She knows the swelling and rash are unusual. Since the next dose is scheduled she was wondering if you had any information. She knows her family reacts differently than others. She is asking if we recommend her getting the second dose?. Therapeutic measures Tylenol was taken because of throbbing at the injection site. The outcome for event "felt a little dizzy but that went away after the 30 minutes" recovered on 22Mar2021. Outcome of the events "developed swelling and redness of both feet"," the left side (side which I got the shot) swelling was also in the feet, under the big toe and also in the right on", "throbbing at the injection site that is only a little pain today but no more throbbing" was recovered on 23Mar2021, Events "developed swelling and redness of both hands", "Adds she also got a muscular or nerve like pain in her neck and down the left side of her back" was recovering. Outcome for events "she felt pain in her left arm", "You can feel the warmth", "I also got the muscle aches, localized swelling and pain at injection site" was unknown.   No follow-up attempts are needed. No further information is expected.