sore at the injection site for the previous vaccines/sore arm at the injection site; This is a spontaneous report received from contactable reporter(s) (Consumer or other non HCP) from medical information team. The reporter is the patient.  An 80-year-old male patient received BNT162b2, BNT162b2 omi ba.4-5 (BNT162B2, BNT162B2 OMI BA.4-5), on 09Sep2022 at 10:00 as dose 5 (booster), single (Lot number: GJ2524) at the age of 80 years intramuscular, in left arm for covid-19 immunisation. The patient's relevant medical history included: "Pacemaker placement", start date: 2021 (unspecified if ongoing); "heart issues" (unspecified if ongoing), notes: He has noticed references to heart issues and he has a pacemaker; "atrial fibrillation" (unspecified if ongoing), notes: recently he had atrial fibrillation and was given two medications. There were no concomitant medications. Vaccination history included: BNT162b2 (DOSE 4 (BOOSTER), SINGLE, Manufacturer: Pfizer , NDC: Unknown , LOT: FJ6369 , EXP: Unknown , Dose and Route: injected into left arm; dose amount unknown , Time: 10AM or so), administration date: 27Apr2022, when the patient was 80-year-old, for Covid-19 immunization, reaction(s): "They did not have any side effects with the previous vaccines except maybe just a sore arm at the injection site"; BNT162b2 (DOSE 3(BOOSTER), SINGLE, Manufacturer: Pfizer , NDC: Unknown , LOT: EW0185 , EXP: Unknown , Dose and Route: injected into left arm; dose amount unknown , Time: 8AM-9AM), administration date: 11Oct2021, when the patient was 79-year-old, for Covid-19 immunization, reaction(s): "They did not have any side effects with the previous vaccines except maybe just a sore arm at the injection site"; BNT162b2 (DOSE 2,SINGLE, Manufacturer: Pfizer  , NDC: Unknown , LOT: EN9581 , EXP: May2021 , Dose and Route: injected into left arm; dose amount unknown , Time: 10AM), administration date: 08Feb2021, when the patient was 78-year-old, for Covid-19 immunization, reaction(s): "They did not have any side effects with the previous vaccines except maybe just a sore arm at the injection site"; BNT162b2 (DOSE 1,SINGLE, Manufacturer: Pfizer  , NDC: Unknown , LOT: EL3249 , EXP: May2021 , Dose and Route: injected into left arm; dose amount unknown , Time: 7PM), administration date: 18Jan2021, when the patient was 78-year-old, for Covid-19 immunization, reaction(s): "They did not have any side effects with the previous vaccines except maybe just a sore arm at the injection site"; Shingles (Had all vaccines, from shingles to whatever), for Immunization.  The following information was reported: VACCINATION SITE PAIN (non-serious), outcome "unknown", described as "sore at the injection site for the previous vaccines/sore arm at the injection site". Relevant laboratory tests and procedures are available in the appropriate section.  Additional information: He and his wife experienced the same situation. They have gotten two of the bivalent boosters for Pfizer COVID-19 vaccine. They had the first shot Jan2021. A second shot in Feb2021. A booster later in the year, 2021 Then a fourth dose in Apr2022. Both got a bivalent COVID-19 Vaccine on 09Sep2022 and a bivalent COVID-19 Vaccine again today 19Jan2023. They did not have any side effects with the previous vaccines except maybe just a sore arm at the injection site. Agent clarifies there was only supposed to be just one bivalent dose given. All previous doses were manufactured by Pfizer and they had no other negative reactions to any of them. The caller confirmed the details provided by the transfer agent. Patient in this report was the caller. Had all vaccines, from shingles to whatever. The minute they bivalent COVID-19 Vaccine became available in their area. Took first bivalent COVID-19 Vaccine on 09Sep2022. Today when having their annual wellness, primary visit with primary doctor, their doctor said the new variant COVID-19 Vaccine was out and their doctor took it. Their doctor states that caller and his wife are always staying current that maybe they wanted to get the new variant COVID-19 Vaccine. Caller and his wife took the variant COVID-19 Vaccines today, went home, looked at their cards, to find out it was the same bivalent COVID- 19 Vaccine. Their primary doctor was an innocent bystander. Caller was assuming that eventually they will end up with some variation of the booster variants every year. He was guessing it was going to be like the Flu shot. Medical staff told caller they usually get 6 or 10 doses out of the thing. Caller and his wife were the first two to get a dose today. Indication: to stay current and their doctor wants them to stay current As soon as the bivalent COVID-19 Vaccine came out in the Fall, after they got it at (Facility Name), their doctor took it also. No further details provided about caller's doctor. Concomitant products: nothing has changed medical conditions: Nothing necessarily. He has noticed references to heart issues and he has a pacemaker. Pacemaker placed: sometime in the year of 2021, but he had issues before the COVID-19 vaccines More recently he had atrial fibrillation and was given two medications. The atrial fibrillation was light, so they didn't want to shock his heart. Appears the atrial fibrillation was gone. Atrial fibrillation: had symptoms of that at night before receiving the COVID-19 vaccines. Thought muscles were twitching before they discovered it was tied in with the heart. When he would lay on his on left shoulder, it felt like a light vibration. He was given the pacemaker, then had Atrial fibrillation, then given the medicine to take care of it. Investigations: none primary doctor and specialist were really good about keeping bloodwork up. caller gave blood today. Clarifies caller and his wife are the reason they got the bivalent COVID-19 Vaccine shot today. They did not think they had it before. Callers' wife states when you are near 80, your mind half-goes. They forgot about the first bivalent shot.