fatigue/increased fatigue/he was weary and tired; pain/pressure in his chest; pain/pressure in his chest; soreness in arms changed to like hurting, and also on his shoulder; eyes sunken in; like with darkness under his eyes; griping in his neck and throat/There was a tightness around his throat and neck; griping in his neck and throat/There was a tightness around his throat and neck; he's not feeling normal/felt whipped out and even looked different; he can't breathe nor walk normally; labored breathing/not able to get a comfortable deep breath on inhale or exhale; felt like a pressure was in his eyes and face; felt like a pressure was in his eyes and face; there was a pain between his shoulder blades; arm soreness; injection site soreness in the arm soreness; lightheaded; 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 67-year-old male patient received BNT162b2, BNT162b2 omi ba.4-5 (BNT162B2, BNT162B2 OMI BA.4-5), on 06Apr2023 as dose 5 (booster), single (Lot number: GK1337, Expiration Date: 14May2023) for covid-19 immunisation. The patient had no relevant medical history. There were no concomitant medications. Vaccination history included: BNT162b2 (DOSE 1, SINGLE, Lot: EN6204), administration date: 18Mar2021, for COVID-19 Immunization, reaction(s): "fatigue", "arm soreness", "injection site soreness in the arm soreness"; BNT162b2 (DOSE 2, SINGLE, Lot: EN6204), administration date: 08Apr2021, for COVID-19 Immunization, reaction(s): "fatigue", "arm soreness", "injection site soreness in the arm soreness"; BNT162b2 (DOSE 3, SINGLE, Lot: FH8020), administration date: 03Nov2021, for COVID-19 Immunization, reaction(s): "fatigue", "arm soreness", "injection site soreness in the arm soreness"; BNT162b2 (DOSE 4, SINGLE, Lot: FN2908), administration date: 06Aug2022, for COVID-19 Immunization, reaction(s): "fatigue", "arm soreness", "injection site soreness in the arm soreness". The following information was reported: PAIN IN EXTREMITY (non-serious) with onset 06Apr2023, outcome "unknown", described as "arm soreness"; VACCINATION SITE PAIN (non-serious) with onset 06Apr2023, outcome "unknown", described as "injection site soreness in the arm soreness"; DIZZINESS (non-serious) with onset 06Apr2023, outcome "unknown", described as "lightheaded"; BACK PAIN (non-serious) with onset 08Apr2023, outcome "unknown", described as "there was a pain between his shoulder blades"; DYSPNOEA (non-serious), outcome "not recovered", described as "labored breathing/not able to get a comfortable deep breath on inhale or exhale"; FATIGUE (non-serious), outcome "unknown", described as "fatigue/increased fatigue/he was weary and tired"; CHEST PAIN (non-serious), CHEST DISCOMFORT (non-serious), outcome "unknown" and all described as "pain/pressure in his chest"; ARTHRALGIA (non-serious), outcome "unknown", described as "soreness in arms changed to like hurting, and also on his shoulder"; EYE DISORDER (non-serious), outcome "unknown", described as "eyes sunken in"; DARK CIRCLES UNDER EYES (non-serious), outcome "unknown", described as "like with darkness under his eyes"; MUSCLE TIGHTNESS (non-serious), THROAT TIGHTNESS (non-serious), outcome "unknown" and all described as "griping in his neck and throat/There was a tightness around his throat and neck"; FEELING ABNORMAL (non-serious), outcome "unknown", described as "he's not feeling normal/felt whipped out and even looked different"; GAIT DISTURBANCE (non-serious), outcome "unknown", described as "he can't breathe nor walk normally"; OCULAR DISCOMFORT (non-serious), FACIAL PAIN (non-serious), outcome "unknown" and all described as "felt like a pressure was in his eyes and face".  Clinical course: Per agent, Caller wanted to know if there was safety information for the Pfizer COVID-19 Bivalent Vaccine administered after its beyond use date. Caller got 4 covid vaccines, primary dose, 2 boosters, and bivalent booster, all of them from Pfizer. He mentioned that he usually felt fatigue and arm soreness for a while, but that he got the bivalent vaccine on 06Apr2023, and today he's still not feeling normal. For this dose he's feeling lightheaded, increased fatigue, he woke up with labored breathing and pain/pressure in his chest, his soreness in arms changed to like hurting, and also on his shoulder, that he felt whipped out and even looked different, like with darkness under his eyes and eyes sunken in, some pain in shoulder blades and pain in his chest that didn't last that long, also griping in his neck and throat, like someone was squeezing his neck but that some minutes later it went away. He added that last Wednesday he felt better but not normal and even on 19Apr2023 he was not feeling normal and continues with pain in shoulder, and that he can't breathe nor walk normally. He wanted to know if someone else has experienced this for this long and what to do to feel better. If there was a difference in the formulation that could have caused this. He also mentioned that he didn't have any COVID-19 symptoms, but that if one could get the vaccine with a previous infection of COVID-19 in case he had the infection without being aware. He also wanted to know why sometimes the expiry was placed as 6 months and other times as 10 weeks, given that his vaccine expires on 14May2023. He also wanted to know if his side effects meant that the vaccine was working and if the fact that we're constantly needing boosters means that the vaccine is wearing off. He just switched to this doctor and relocated and it was hard to find a new doctor. He had previously taken his original Pfizer COVID vaccinations when they first came out. He got the first two vaccines 2 weeks apart. Then, in 6-8 months he got his first booster. Then, 6-8 months later her got a second booster. He had relatively the same side effects for those. His side effects were common and expected. They all cleared up by the following evening by the most part. This time he received a Bivalent booster, and everything was different. It has been 2 weeks now since he received the shot, but he still doesn't feel 100%. He has an array of symptoms he went through: This is the first time minutes after the shot that he was feeling lightheaded. He didn't experience that before with the previous vaccines. All the other shots, they asked him to sit for 10 minutes before he left, and each time everything was okay. This time they didn't tell him to sit, and this is the time he felt lightheaded. He sat in the car 20 minutes. And everything felt okay. Typically with the other injections, a few hours later, he started feeling fatigue and then later in the evening injection site soreness in the arm soreness. Besides being lightheaded after the Bivalent booster, he thought everything was like the other ones. Then, he woke up in the middle of the night with labored breathing and pain / pressure in his chest. He had a soreness in his arm that wasn't soreness anymore it was hurting. It was so painful that even the other shoulder felt like it was bothering him. He decided to sleep it off. The next morning, he felt really wiped out. Usually he only felt a little wiped out. He was able to get around. He was not bedridden, but he was weary and tired. Which was probably from the rough night and fatigue lasting into the next day which happened with prior shots. The next few days felt like his breathing was not natural. He was feeling like he was not able to get a comfortable deep breath on inhale or exhale. One evening when sitting watching television, he still had a slight pressure in his chest on and off for a couple of days. He got the shot on Thursday. Friday: he was wiped out. Saturday: still had slight discomfort in his chest then in the evening out of nowhere there was a pain between his shoulder blades. The pain in his chest was new. He has never had issues with his heart. That lasted anywhere from a half an hour to 1.5 hours. He felt like somebody was gripping his neck and throat. Like slightly gripping it. There was a tightness around his throat and neck. It was the weirdest sensation. It only lasted several minutes and then disappeared. Since last Wednesday, 12Apr2023, he has finally started feeling a little like he was turning around. He was feeling a little better, but still not normal. Last night, he did have a pain behind his shoulder blade that went away. The tightness in his chest has not been bothering him. During the first week in addition to the symptoms reported above, his eyes looked sunken in, and he looked terrible. His coloring was not great. It felt like a pressure was in his eyes and face. He is usually a walker. He will walk 3-4 miles 2-3 times a week. He tried to do that, but it didn't go as smooth as usual. His eyes still look sunken in a little. He still doesn't feel like he is breathing naturally. He doesn't how much the breathing is anxiety from his experience. This was his first appointment at a new doctor's office. They were very nice and so was the office. They offered him the Bivalent booster there. He had received mixed answers between doctors on whether to get the Bivalent booster or not. He went with the Bivalent booster in the office that day. His first 4 vaccines were all Pfizer so he wanted to stick with it. At first the office offered him Moderna. He didn't want to do that. They found a Pfizer Bivalent booster for him. Sender's Comments: Linked Report(s): US-PFIZER INC-202300163844 same patient, different vaccine dose/event.