Feeling uncomfortable/discomfort located above the elbow and has migrated to the left side of her back; I could hardly lift my arm; Started hurting really bad/feel pain on the left arm/located at the left deltoid and bellow the shoulder; Pain at the injection site; Pain located above the elbow and has migrated to the left side of her back; This spontaneous case was received on 30-Nov-2022 from Agency (reference number: SEQW22-06149), reported by other health care professional (nurse) and concerned a 73-year-old, female patient.  The patient's concurrent conditions included glaucoma, bone and heart conditions. The patient's concomitant medications included latanoprost (eye drops), Ibandronate (ibandronate sodium), losartan, amlodipine, metoprolol, Pravacol (pravastatin sodium), vitamin D3, and calcium, and fish oil, all used for unreported indications. The patient's historical vaccine included booster dose of Moderna Covid-19 vaccine (elasomeran), received on 24-Aug-2022, and after which the patient had no adverse events reported.  On 14-Oct-2022, the patient was vaccinated with Fluad Quadrivalent (influenza vaccine inact sag 4v; dose: 0.5ml, route of administration: intramuscular, and anatomical location: left arm) for prevention of influenza disease. The batch number reported was 346365, and expiration date: 20-May-2023.  On the same date, at late afternoon, after receiving Fluad Quadrivalent, the patient started to feel pain on the left arm (arm which received the flu injection), felt uncomfortable and could hardly lift her arm. The pain was located at the left deltoid and below the shoulder.   On an unspecified date in Oct-2022 the patient recovered from event of ' painful L arm'. The pain lasted for more or less four days and after that, it disappeared.  On an unspecified date in Oct-2022 (reported as late October), the patient started to feel pain at the injection site.  On an unspecified date in 2022, between last week of October and first week of November, after returning from a plane trip, the pain and discomfort started again. As reported, the pain had been intensified. The pain and discomfort were enormous (patient stated that on a scale from 0-10, where 0 was no pain and 10 was severe, could describe as 7-8). The pain and discomfort were located above the elbow and had migrated to the left side of her back. The patient stated that she was planning to see a doctor on 01-Dec-2022 and needed to know what to tell him.  At the time of initial reporting on 30-Nov-2022, the patient had not recovered from events of 'discomfort', 'mobility decreased', 'pain' and 'vaccination site pain'   The reporter did not provide a causality assessment.  The case was assessed as non-serious.  This case is linked with case 202208654 (the same patient and reporter).  Company comment: A 73-year-old female patient experienced pain, discomfort, pain in extremity and mobility decreased on the same date after vaccination with the suspect Fluad Quadrivalent vaccine. On an unspecified date the patient also experienced vaccination site pain. Information regarding the related diagnostic findings was not provided. Causality is assessed as possibly related for all events based on plausible temporal relationship.; Sender's Comments: A 73-year-old female patient experienced pain, discomfort, pain in extremity and mobility decreased on the same date after vaccination with the suspect Fluad Quadrivalent vaccine. On an unspecified date the patient also experienced vaccination site pain. Information regarding the related diagnostic findings was not provided. Causality is assessed as possibly related for all events based on plausible temporal relationship.