Deltoid soreness; pretty crummy immune system; Injection site deltoid soreness; This is a spontaneous report received from a contactable reporter(s) (Physician). The reporter is the patient.  A 72-year-old male patient received BNT162b2, BNT162b2 omi ba.4-5 (BNT162B2, BNT162B2 OMI BA.4-5), on 14Oct2022 as dose 5 (booster), single (Lot number: GJ26234) at the age of 71 years, in left deltoid for covid-19 immunisation. The patient's relevant medical history included: "IGA deficient" (ongoing), notes: He is 100% IGA deficient; "IgG monoclonal gammopathy" (ongoing); "sinopulmonary infections" (unspecified if ongoing); "prone to acute bronchitic infections" (ongoing); "prone to chronic bronchitic infections" (ongoing); "pulmonary system compromise" (unspecified if ongoing); "immuno system compromise" (ongoing); "primary immune system abnormality that is congenital" (ongoing); "arthritic" (unspecified if ongoing); "Covid", start date: Feb2020 (unspecified if ongoing), notes: Covid was first hitting the news in Feb2020; "sinopulmonary infections" (unspecified if ongoing); "bronchiectasis" (unspecified if ongoing). Concomitant medication(s) included: INFLUENZA VACCINE taken for influenza immunisation, on 06Oct2022 as dose number unknown, single. Vaccination history included: BNT162b2 (DOSE 1, SINGLE, Batch/lot number: EL9265, Location of injection: left deltoid), administration date: 18Feb2021, for COVID-19 Immunization, reaction(s): "deltoid soreness"; BNT162b2 (DOSE 2, SINGLE, Batch/lot number: EN6204, Location of injection: left deltoid), administration date: 11Mar2021, for COVID-19 Immunization, reaction(s): "deltoid soreness"; BNT162b2 (DOSE 3 (BOOSTER), SINGLE, Batch/lot number: EY0584, Location of injection: left deltoid), administration date: 16Aug2021, for COVID-19 Immunization, reaction(s): "deltoid soreness"; BNT162b2 (DOSE 4 (BOOSTER), SINGLE, Batch/lot number: FS6869, Location of injection: left deltoid), administration date: 12Jan2022, for COVID-19 Immunization, reaction(s): "bleeding in lungs", "epiglottitis", "swallowing was so difficulty in Aug2022", "deltoid soreness", "he had pretty bad hemoptysis/He had hard productive cough and bright red blood productive cough that lasted for 2 weeks"; flu shot (DOSE NUMBER UNKNOWN, SINGLE), administration date: 14Oct2019, for Immunization, reaction(s): "deltoid soreness"; flu shot (DOSE NUMBER UNKNOWN, SINGLE), administration date: 16Sep2020, for Immunization, reaction(s): "deltoid soreness"; flu shot (DOSE NUMBER UNKNOWN, SINGLE), administration date: 27Sep2021, for Immunisation, reaction(s): "deltoid soreness"; pneumococcal polysaccharide ppsv 13 (DOSE NUMBER UNKNOWN, SINGLE), administration date: 20May2015, for Immunisation, reaction(s): "deltoid soreness"; pneumococcal conjugate 23 (DOSE NUMBER UNKNOWN, SINGLE), administration date: 27Sep2021, for Immunisation, reaction(s): "deltoid soreness"; measles mumps rubella (DOSE NUMBER UNKNOWN, SINGLE), administration date: 16Sep2013, for Immunisation. The following information was reported: MYALGIA (non-serious), outcome "unknown", described as "Deltoid soreness"; IMMUNE SYSTEM DISORDER (non-serious), outcome "unknown", described as "pretty crummy immune system"; VACCINATION SITE PAIN (non-serious), outcome "recovered", described as "Injection site deltoid soreness".  Additional information: Caller was a retired cranial facial surgeon. He was trained at (Place withheld). He had a pretty crummy immune system. He had question about the upcoming RSV vaccine. With each injection of Covid vaccine he had localized deltoid soreness for a day or a day and half. He had no remarkable reaction in the series. He had follow-up dose being he was over age 65 and had pulmonary and immuno system compromised. Because of EG5 and BA286 he planned to get a 6th Covid injection when it comes available in September. His age put him at risk and had primary immune system abnormality that was congenital and gets a lot of sinopulmonary infections. He saw pulmonologist and had cat scan documented evidence of bronchiectasis in right middle lobe and left lower lobe. Caller had first episode of Covid when Covid was first hitting the news in Feb2020. He had host of medical issues primarily arthritic. They were unrelated. The only time he had had deltoid soreness was with Covid vaccine or annual flu shot or pneumonia vax. It was transient and temporary. Caller clarified that he doesn't know the manufacturers of the flu shots he has had or the pneumonia vaccines. He received first two vaccines at a (hospital name withheld), third and fourth Dose were given at (facility name withheld). He got the booster at a (withheld) store pharmacy.; Sender's Comments: Linked Report(s) : US-PFIZER INC-202300288361 same patient/drug, different dose/event.;