arm was hot. It felt like a hot burning knife in her arm for a month.; Last night, still could not sleep because of the pain in her arm; Soreness in arms; swollen; Pain in arm/red with sharp, severe pain for a long time; dizzy/lightheaded; first two shots were Moderna Covid vaccines/ third shot was Pfizer; Off label use; 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 70-year-old female patient received BNT162b2 (BNT162B2), on 20Dec2021 as dose 3 (booster), single (Lot number: FJ8757) at the age of 70 years, in left arm for covid-19 immunisation. The patient's relevant medical history included: "Arthritis" (unspecified if ongoing), notes: Arthritis Thinks diagnosed in 1995, but was not sure; "Thyroid removed because she had a benign mass" (unspecified if ongoing), notes: Had no thyroid Thyroid removed because she had a benign mass. Still has her parathyroid Been on Synthroid for many years. There were no concomitant medications. Past drug history included: Synthroid, notes: Had no thyroid .Thyroid removed because she had a benign mass. Still has her parathyroid Been on Synthroid for many years. Vaccination history included: moderna coviD-19 vaccine (DOSE 1,S INGLE; F8MO or FBMO from the vaccine record card.Thinks its FBMO; Anatomical location: right arm), administration date: 14Jan2021, when the patient was 69-year-old, for COVID-19 Immunisation, reaction(s): "she had pain", "swelling in her arm"; moderna coviD-19 vaccine (DOSE 2; SINGLE; FBMO from the vaccine record card, Anatomical location: right arm), administration date: 11Feb2021, when the patient was 69-year-old, for COVID-19 Immunisation, reaction(s): "she had fever", "chills", "pain in the arm", "palpitations", "chest pain", "body aches", "her brain was swollen inside of her skull", "pain in her eyes", "couldn't get out of bed and couldn't do anything.". The following information was reported: OFF LABEL USE (non-serious) with onset 20Dec2021, outcome "unknown"; PAIN IN EXTREMITY (non-serious) with onset 20Dec2021, outcome "unknown", described as "Pain in arm/red with sharp, severe pain for a long time"; DIZZINESS (non-serious) with onset 20Dec2021, outcome "unknown", described as "dizzy/lightheaded"; INTERCHANGE OF VACCINE PRODUCTS (non-serious) with onset 20Dec2021, outcome "unknown", described as "first two shots were Moderna Covid vaccines/ third shot was Pfizer"; SWELLING (non-serious), outcome "unknown", described as "swollen"; FEELING HOT (non-serious), outcome "unknown", described as "arm was hot. It felt like a hot burning knife in her arm for a month."; SLEEP DISORDER (non-serious), outcome "unknown", described as "Last night, still could not sleep because of the pain in her arm"; PAIN IN EXTREMITY (non-serious), outcome "recovering", described as "Soreness in arms". The events "swollen", "pain in arm/red with sharp, severe pain for a long time", "arm was hot. it felt like a hot burning knife in her arm for a month.", "last night, still could not sleep because of the pain in her arm", "soreness in arms", "dizzy/lightheaded" and "first two shots were moderna covid vaccines/ third shot was pfizer" required physician office visit. Therapeutic measures were not taken as a result of feeling hot, sleep disorder, pain in extremity, dizziness.   Additional information: Caller reported that both arms are still sore from previous vaccine, wanted to get 4th dose of covid vaccine but she does not want it in the arm, alternative locations where vaccine can be given. Caller asked if it was unusual for her to still be experiencing pain in her arms since she got the vaccine back in December. Caller reported that pain is not as severe as it was at first and her whole arm blew up. Caller reports she received Pfizer BioNtech covid 19 vaccines in her left arm last time, should she do it in the right arm this time even if she was still experiencing pain. Caller also asked if she should even get another dose. Her first two shots were Moderna Covid vaccines and she had pain and swelling in her arm after. With the second Moderna shot, she had fever, chills, and all that too. Her third shot was Pfizer. She had less symptoms with that shot, but did have symptoms. She got the Pfizer covid vaccine on 20Dec2022 and it was swollen after and she still has pain in the arm. She still has pain in the arm from the second Moderna dose as well. Wants to get a fourth Covid vaccine. Can she get the vaccine in her buttocks or somewhere else besides her arms. Caller was the patient. Transferred from (name withheld) with Pfizer DSU . But caller didn't fill out a safety report when she was speaking. Callers had previous COVID-19 vaccine in both arms and arms are still sore. The caller confirmed the details provided by the transfer agent. The first two COVID-19 Vaccines were Moderna, her third one on 20Dec2021 was Pfizer. Caller states the next day the soreness started, but then it got progressively worse. Only got the Pfizer COVID-19 vaccine injection one time. The first day after the Pfizer COVID-19 Vaccine was not good. The second day, it really blew up and was red with sharp, severe pain for a long time, but this was 20Dec2021. Still had pain, it's not bad like it was in the beginning, but still does have pain. Because the second Moderna shot she had a very severe reaction of fever, palpitations, chest pain, chills, body aches and felt as though her brain was swollen inside of her skull. It even hurt to think, she could not get out of bed and could not do anything. Had very bad pain in her eyes. Was very apprehensive and her doctor told her to go with Pfizer COVID-19 Vaccine because it has less side effect, which it did. With the Pfizer COVID-19 Vaccine: She did not feel well for a week. The pain in her arm was intense. Side effects were less than Moderna COVID-19 Vaccine. She does had pictures of her arm, it swelled up. Her arm was hot. It felt like a hot burning knife in her arm for a month. Still had some pain. Last night, still couldn't sleep because of the pain in her arm. It kept her up last night. The pain radiated down her arm into her hand and up into neck and in shoulder. Clarified that is on both arms. Clarifies the Pfizer COVID-19 Vaccine injection was given in her left arm. Both Moderna COVID-19 Vaccine was given in her right arm. She wanted to get another shot, does not know what to do, is supposed to go tomorrow. Immediately after the Pfizer COVID-19 Vaccine, she was lightheaded and dizzy, but did not tell the (pharmacy name) staff. She stayed for 15 minutes and left. She did not pass out. There was no history of all previous immunization with the Pfizer vaccine considered as suspect (or patient age at first and subsequent immunizations if dates of birth or immunizations are not available. There were no additional vaccines Administered on Same Date of the Pfizer Suspect. There was no Emergency Room required. Physician Office On 23Dec2021 had a virtual urgent care visit. Urgent case is affiliated with the Hospital. She also did the urgent care virtual visits after her Moderna COVID-19 Vaccines. There were no prior Vaccinations within 4 weeks. There was no family Medical History Relevant to Adverse events. On the 4th COVID-19 Vaccine, are there less side effect than the first three? Offered transfer. Stated that the agent could not answer too many questions and referred caller to her doctor.Had no thyroid and thyroid removed because she had a benign mass. Still has her parathyroid Been on Synthroid for many years