arm got really sore this time, just hanging down walking across the room it hurt, it was sore if someone touched the injection site; some odd red spots on her arm about 4 inches down from the injection site/2 red spots about the size of a quarter; arm is visibly swollen and painful/left arm is swollen and visibly larger than her right arm; has a bruise in between the red spots and the injection site as well; has a bruise in between the red spots and the injection site as well; the spots as feeling a little hard and raised but not a fully formed bump; red spots are tender and swollen, kind of like a lump but they are sore; red spots are tender and swollen, kind of like a lump but they are sore; arm got really sore this time, just hanging down walking across the room it hurt, it was sore if someone touched the injection site; tired and fatigued; This is a spontaneous report from a contactable consumer (patient) received via medical information team. A 56-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; Lot Number: EP7534), via an unspecified route of administration in left arm on 01Apr2021 (at the age of 56-years-old) as dose 2, single for COVID-19 immunization. Medical history included type 2 diabetes mellitus, overweight and pneumonia (She was hospitalized in Jan2020 with double pneumonia). Historical vaccine included BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number and expiration date were not reported), via an unspecified route of administration on 11Mar2021 (at the age of 56-years-old) as dose 1, single for COVID-19 immunization and experienced extreme fatigue and sore arm. The patient also received flu shot for influenza immunization and it bubbled up under her skin.  Concomitant medications included dulaglutide (TRULICITY) taken for diabetes from an unspecified start date and ongoing at 1.5ml once weekly, taken for a year; metformin taken for diabetes from an unspecified start date and ongoing at 500 mg, 2x/day, taken over a year, maybe 2 years; atorvastatin taken for cholesterol from an unspecified start date and ongoing as 20 mg, 1x/day taken about a year to guard her heart; dapagliflozin propanediol monohydrate (FARXIGA) taken for diabetes from an unspecified start date and ongoing as 10 mg, 1x/day taken 6 or 7 months; acetylsalicylic acid (BABY ASPIRIN) taken from an unspecified start date and ongoing; chondroitin sulfate, glucosamine hydrochloride (OSTEO BI-FLEX) taken from an unspecified start date and ongoing and vitaprime: (Contains Vitamins A,C,D,E,K, thiamine, riboflavin, niacin). Prior to vaccination, the patient did not receive any vaccines within four weeks. The patient experienced arm got really sore this time, just hanging down walking across the room it hurt, it was sore if someone touched the injection site and tired and fatigued on 01Apr2021, arm got really sore this time, just hanging down walking across the room it hurt, it was sore if someone touched the injection site, some odd red spots on her arm about 4 inches down from the injection site/2 red spots about the size of a quarter, arm is visibly swollen and painful/left arm is swollen and visibly larger than her right arm, has a bruise in between the red spots and the injection site as well, the spots as feeling a little hard and raised but not a fully formed bump, red spots are tender and swollen, kind of like a lump but they are sore on 06Apr2021.   On 06Apr2021 she noticed about 4 inches down from the injection site on her left arm, she has 2 red spots about the size of a quarter. Her left arm is swollen and visibly larger than her right arm. She has a bruise in the middle of those 2 red spots.  She hasn't been anywhere else in the past week that she can think of where she would have gotten these 2 red spots and a bruise. Patient tried to call her doctor, but he has recently left his practice and the doctor's office didn't have any openings. The doctor office told her to go to urgent care. She doesn't think this is an urgent care situation. She's asking if it's a normal reaction or an occurring reaction. Patient reported that she noticed her arm last night, 06Apr2021, while she was getting ready for bed and she looked in the mirror. Those red spots are tender and swollen, kind of like a lump, but they are sore. She reported she has been tired and fatigued. She feels better every day. With the first Covid 19 vaccine she had extreme fatigue and her arm got sore the next day after receiving the Covid 19 vaccine. Her left arm with the second vaccine got sore later the same day that she received the vaccine. Even walking with her arm hanging down it was sore. Her arm had started being less sore, more soreness isolated at the injection site, just sore to touch. But then yesterday, 06Apr2021 when she was getting ready to take a shower before bed, she noticed she had those 2 red spots on her arm, and she saw the bruise. She thought that's strange for those red spots to appear almost a week after she received the vaccine.  Patient didn't know what to do. She thought she would wait another 24 hours and then report it. She did call her sister who is a retired health medical professor, and her sister hadn't heard of that side effect. As far as her fatigue, she reports yesterday she was feeling pretty good and not napping as much. She reports she slept pretty much all-day Saturday, 03Apr2021 and Sunday, 04Apr2021. She is more alert and doesn't have much fatigue today. She thinks she's at about 98% now. She reported that she qualified to receive the Covid 19 vaccine because she's a high risk because she has type 2 diabetes, and she is overweight. She has also had multiple rounds of pneumonia in the past. She thinks she had the Covid 19 virus in Jan2020. She was hospitalized in Jan2020 with double pneumonia. The emergency room doctor told her lungs sounded like a washing machine. The chest x-ray did not show the pneumonia, so she had to have a CT scan of her chest. She was at a New Year's Evening party with about 40 people and all 40 people got sick. She's the only one who had to be hospitalized. All 40 people had various symptoms. She wasn't coughing anything up and she thinks she had more Covid 19 virus symptoms. Hospitals were not testing for Covid 19 at that time. The Covid 19 antibody test was available in May2020 so she had that done and it showed negative Covid 19 antibodies. She doesn't think those early antibody tests were accurate. Outcome of event tired and fatigued was resolving. Outcome of remaining events was not resolved.  No follow-up attempts are possible. No further information is expected.