around her arm hurt where the injection site was/injection site hurting; felt so sick; felt like had a fever; was just miserable/felt terrible; she lifted up her arm it hurt; her face was red; felt like a 24 hour flu type situation; This is a spontaneous report received from a contactable reporter (Consumer). The reporter is the patient.  A 77-year-old female patient received BNT162b2, BNT162b2 omi ba.4-5 (BNT162B2, BNT162B2 OMI BA.4-5), on 29Sep2022 as dose 4 (booster), single (Lot number: 6H9702) at the age of 77 years, in left arm for covid-19 immunisation. The patient's relevant medical history included: "hip problems" (ongoing). There were no concomitant medications. Past drug history included: Cortisone for hip problems. Vaccination history included: BNT162b2 (Dose:1, Lot no: EL9264), administration date: 29Jan2021, when the patient was 75-year-old, for COVID-19 Immunization, reaction(s): "Chills", "felt so bad so went back to bed all day"; BNT162b2 (Dose: 2, Lot no: EN6198), administration date: 19Feb2021, when the patient was 75-year-old, for COVID-19 Immunization, reaction(s): "did not feel good with the 2nd covid vaccine"; BNT162b2 (Dose:3, lot no: 3313084), administration date: 15Dec2021, when the patient was 76-year-old, for COVID-19 Immunization, reaction(s): "3rd covid vaccine, the side effects were kind of mild". The following information was reported: VACCINATION SITE PAIN (non-serious) with onset 30Sep2022, outcome "recovering", described as "around her arm hurt where the injection site was/injection site hurting"; INFLUENZA LIKE ILLNESS (non-serious) with onset 30Sep2022, outcome "unknown", described as "felt like a 24 hour flu type situation"; PYREXIA (non-serious) with onset 30Sep2022, outcome "recovered" (01Oct2022), described as "felt like had a fever"; MALAISE (non-serious) with onset 30Sep2022, outcome "unknown", described as "felt so sick"; ERYTHEMA (non-serious) with onset 30Sep2022, outcome "recovered" (01Oct2022), described as "her face was red"; PAIN (non-serious) with onset 30Sep2022, outcome "unknown", described as "she lifted up her arm it hurt"; FEELING ABNORMAL (non-serious) with onset 30Sep2022, outcome "unknown", described as "was just miserable/felt terrible".  Additional information: Bivalent vaccine was administered in upper left arm. The patient got this dose on 29Sep2022 and on the next day she woke up and her arm, around her arm hurt where the injection site was, and she expected that, and she felt so sick she had to lay on the couch all day long and she felt like had a fever and she was just miserable. Was excepting the injection site hurting and when she lifted up her arm it hurt and thought that must be from the injection and that seems to be a lot better. Was on the couch all day long and was miserable and felt like she had a fever especially on her forehead and it was like her face was red and she had a fever and felt terrible and states it was not ongoing and lasted she would say for 24 hours and then the next day she felt pretty good, and it was almost all gone but she was really miserable. The patient had no treatment for the reported event and it felt like a 24 hour flu type situation and in the morning the next morning she woke up and felt a lot better and it seemed like it pretty much went away. She does not know about taking another covid shot as they are talking about one a year in the future. Had two prior cortisone shots and has been having a hip problem which was before the Pfizer covid vaccines and has been having the hip problem the last few years and it was not something that just started recently. She also got a shot of cortisone and another shot and does not know if that one was cortisone also because she went to a different doctor and they gave her a shot that appeared to be like cortisone and she went second time and they gave her a shot and she was not sure if it was cortisone or hydronic and has no name for the shot and thinks it was on 14Sep2022; has no lots, expiry dates or NDC numbers for the cortisone shot or the other shot she does not know the name of and states the cortisone shot did not work and she ended up and decided to go to another place that gave her the different shot that helped. Additional vaccines administered on same date of the Pfizer suspect was none. The patient was supposed to have a flu shot that day too in her other arm and because she had gotten cortisone shots and all these shots she said no to the flu shot and just received the one shot for the Pfizer Bivalent covid vaccine. Decided to get the flu shot later on this year. The patient did not visit emergency room or physician Office. She had adverse events with her prior covid vaccine and it has been so long ago that it just seems to her the 1st vaccine she had chills and got up in the morning and the chills were so bad she was going to take a shower and could not take a shower because she just had felt so bad so went back to bed all day and believes that was with her 1st dose of Pfizer covid vaccine; it was hard and she does not really remember but did have side effects but they weren't so bad but just did not feel good with the 2nd covid vaccine and her 3rd covid vaccine, the side effects were kind of mild but she did have side effects but does not remember what they were. No relevant tests were done. The patient asked if it just is typical to have this or does a lot of people have side effects reported to Pfizer; her sister did not have anything and had no effects and did not have one effect and had two shots which were the flu shot and the covid shot and she 5 years older than patient and clarified her sister had nothing in terms of side effects.  Follow-up attempts are completed. No further information is expected.