Caller usually has one or two flares of Rheumatoid Arthritis a year and she had the first one this year and she described it as "worst one she ever had."/the worst rheumatoid arthritis flare; This is a spontaneous report received from Pfizer sponsored program from a contactable consumer (patient herself).  A 54-years-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot number was not reported), dose 2 via an unspecified route of administration on an unspecified date as DOSE 2, SINGLE for covid-19 immunisation. Medical history included ongoing rheumatoid arthritis. Concomitant medication(s) included tofacitinib citrate (XELJANZ), 5mg twice daily taken for rheumatoid arthritis from an unspecified date and ongoing. Historical vaccine included bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Batch/Lot number was not reported), dose 1 via an unspecified route of administration on an unspecified date as DOSE 1, SINGLE. It was reported that she has taken both doses of the COVID vaccine. She has rheumatoid arthritis. She has taken Xeljanz for several years. On an unspecified date in 2021, she stated she is having her first flare of Rheumatoid arthritis since she received the COVID vaccine. This is the worst flare of her life after receiving the COVID vaccine. She is not sure she wants to take the COVID booster. She wants to know if "booster dose" is recommended for patient like her with Rheumatoid Arthritis. The caller confirmed the details provided by the agent. She is perfectly fine. Her husband works in research so she knows it is important . Caller declined email. If she does file this report will that prevent her insurance from covering her Xeljanz. She doesn't know the dates of her vaccines off hand. She got it whenever vaccines initially became available for immunocompromised patients. She thinks it was like late spring. She thinks there was an April date involved. She didn't have a flare associated with either injection. She has one to two flares a year. This is her first flare this year. It has be uncontrollable. It has been the worst she has had. She has been on an oral steroid to try to get it under control. A week ago is when this flare started. It is still flaring. It has improved only while on high levels of prednisone. She stopped the prednisone yesterday. Now she is on high doses of Ibuprofen, but it didn't wipe it out . The hope is that the high dose steroids will knock it out. Caller doesn't have the lot/expiration for the Prednisone and Ibuprofen. She doesn't have the lot/expiration for the Xeljanz because she just combines all the pills into one bottle. She doesn't want to give that information at this time. She takes 5mg twice daily. She did start taking Hydroxychloroquine again when COVID started. Her rheumatoid arthritis was not exactly 100% in control because they did cut back on her Xeljanz for a while because she had liver enzyme elevation. She just got back to taking the Xeljanz twice a day because her inflammation was not under control. She doesn't have the lot/expiration for the hydroxychloroquine. It was filled at medical clinic, and she doesn't see the information. It was their pharmacy. She doesn't have the lot/expiration for the Xeljanz because she just combines all the pills into one bottle. She did start taking Hydroxychloroquine again when COVID started. Her rheumatoid arthritis was not exactly 100% in control because they did cut back on her Xeljanz for a while because she had liver enzyme elevation. She just got back to taking The Xeljanz twice a day because her inflammation was not under control. She doesn't have the lot/expiration for the hydroxychloroquine. It was filled, and she doesn't see the information. It was their specialty pharmacy. Lab test included liver enzyme elevation. The outcome of worst rheumatoid arthritis flare was recovering.  The lot number for the vaccine BNT162B2 was not provided and will be requested during follow up.