she got very ill; ad severe pain and mobility problems; ad severe pain and mobility problems; flare of her rheumatoid arthritis; This is a spontaneous report from a contactable consumer (patient). A 77-year-old female received second dose of BNT162B2 (lot number EL9269) on 11Feb2021 (at age of 77-year-old) at single dose on left arm for Covid-19 immunization. Co-suspect product included tofacitinib citrate (XELJANZ) from unspecified date and ongoing at 5 mg twice daily for rheumatoid Arthritis. Medical history included ongoing rheumatoid Arthritis. Concomitant medications included ongoing methotrexate for rheumatoid Arthritis, ongoing hydroxychloroquine, prednisone from unspecified date and Jul2021, folic acid. Historical vaccine included first dose of BNT162B2 (lot number EL1283) on 22Jan2021 (at age of 77-year-old) on left arm for Covid-19 immunization. She was taking xeljanz 5 mg twice daily for years for severe rheumatoid Arthritis. Her Dr. wants her to have a booster dose of the Pfizer covid vaccine and wants her to be off xeljanz for a week after the booster dose. asking for pfizer's recommendations on when to stop xeljanz. Added she received a 2nd dose of pfizer covid vaccine on 11Feb and 12 days later she experienced a flare of her rheumatoid arthritis on 23Feb2021 which lasted till end of May2021. States with the flare, she got very ill, had severe pain and mobility problems especially in her shoulders and knees. She was treated with high doses of prednisone, received coritisone shots, took aleve and tylenol. She got cortisone shots in her shoulder and knees, and they made no difference. She took Aleve and Tylenol more often than normal. She took high doses of Prednisone, and none of that helped. Finally, she was given Meloxicam 15 mg which helped almost immediately. States at the time of her pfizer covid vaccine doses, she was taking xeljanz, methotrexate, hydroxychloroquine and prednisone. she has since weaned off prednisone as of Jul2021. states no one told her to stop those medications before/after the covid vaccines. she was told by a provider that because she was on so many immunosuppressants, she had 'a blunted effectiveness' of the vaccine. States this was general information she was told and not due to any presenting. She recovered completely from her flare up. She just never fully recovers with her rheumatoid arthritis. She did go down to her normal degree of Rheumatoid Arthritis. This was an extreme flare, and she did recover. She continued to take Xeljanz, Methotrexate, Hydroxychloroquine, and prednisone when she got the COVID vaccine. She also takes folic acid. She is on Methotrexate 2.5mg seven tablets, once a week. NDC:68382-775-01. Medication is in a pharmacy bottle so she is unable to provide Lot number. Expiration is 31May2022. Her Hydroxychloroquine NDC is 43598-0721-01, and it is good until May2022. She doesn't have the lot. She has no information on the Prednisone  because she is not taking it anymore. She doesn't have NDC/lot/expiration. She called because she wanted information on what to do for the booster. Should she stop her immunosuppressant drugs? She didn't get anymore information than she already had. She is afraid to go off her medications for it because she never has. She will have a flare up. Her doctor thinks she needs the booster though. Caller was referred to her doctor. The action taken for tofacitinib citrate was dose not changed. The outcome of the event flare of her rheumatoid arthritis was recovered in May2021 (duration reported as 67 days). The outcome of other events was unknown. The Seriousness was no.