Flu-like illness; extreme muscle aches; chills; light-headedness; unable to stand for more than a few seconds without the feeling of passing out; fever; headache; fatigue; I was unable to carry on daily tasks; The initial case was missing the following minimum criteria: ICH - Unspecified AE. Upon receipt of follow-up information on (02Dec2022), this case now contains all required information to be considered valid.  This is a spontaneous report received from a contactable reporter(s) (Pharmacist). The reporter is the patient.  A 26-year-old female patient received BNT162b2 (BNT162B2), on 04Feb2021 at 16:00 as dose 2, single (Lot number: ZM9809) at the age of 24 years intramuscular, in right deltoid for covid-19 immunisation. The patient had no relevant medical history. The patient's concomitant medications were not reported. Vaccination history included: BNT162b2 (Dose: 1st, Date: 14Jan2021, Time: Approx. 16:00, Anatomical Site of injection: Right deltoid, Route of Administration: Intramuscular, Batch/Lot Number: EL0142), administration date: 14Jan2021, when the patient was 24-year-old, for COVID-19 Immunization, reaction(s): "Intense diarrhea"; BNT162b2 (Dose: 1st, Date: 14Jan2021, Time: Approx. 16:00, Anatomical Site of injection: Right deltoid, Route of Administration: Intramuscular, Batch/Lot Number: EL0142), administration date: 14Jan2021, when the patient was 24-year-old, for COVID-19 immunization, reaction(s): "Extreme abdominal cramping", "Bloating", "Gas", "GI upset", "Unable to carry on daily tasks". The following information was reported: INFLUENZA LIKE ILLNESS (non-serious) with onset 05Feb2021, outcome "recovered" (06Feb2022), described as "Flu-like illness"; LOSS OF PERSONAL INDEPENDENCE IN DAILY ACTIVITIES (non-serious) with onset 05Feb2021, outcome "recovered" (06Feb2022), described as "I was unable to carry on daily tasks"; CHILLS (non-serious) with onset 05Feb2021, outcome "recovered" (06Feb2022); MYALGIA (non-serious) with onset 05Feb2021, outcome "recovered" (06Feb2022), described as "extreme muscle aches"; FATIGUE (non-serious) with onset 05Feb2021, outcome "recovered" (06Feb2022); PYREXIA (non-serious) with onset 05Feb2021, outcome "recovered" (06Feb2022), described as "fever"; HEADACHE (non-serious) with onset 05Feb2021, outcome "recovered" (06Feb2022); DIZZINESS (non-serious) with onset 05Feb2021, outcome "recovered" (06Feb2022), described as "light-headedness"; PRESYNCOPE (non-serious) with onset 05Feb2021, outcome "recovered" (06Feb2022), described as "unable to stand for more than a few seconds without the feeling of passing out". Therapeutic measures were not taken as a result of influenza like illness, myalgia, chills, dizziness, presyncope, pyrexia, headache, fatigue, loss of personal independence in daily activities.  Additional information: Patient experienced negative side effects following the fourth COVID booster vaccine (bi-valent). These side effects included muscle aches, headache, and chills for one day, as well as a red, swollen, itchy, and warm injection site (commonly known as COVID arm) for approximately three days. Optional Information: Patient has previously received the initial two Pfizer shots, a Moderna booster, and now this bivalent Pfizer booster. Patient has reacted poorly to all COVID vaccines to date, with each reaction being different in symptoms. Patient has no cormorbidities and is currently not taking any medication. Prior Vaccinations (within 4 weeks): None. Concomitant Drugs: Drug Name: Advil (ibuprofen), Reason for Use: Headache, route: Oral, Start Date: 17Nov2022, Stop Date: 17Nov2022. Drug Name: Tums (calcium carbonate), Reason for Use: Acid reflux, Route: Oral, Start Date: 24Nov2022, Stop Date: 26Nov2022. Patient's Medical History (including any illness at time of vaccination): None, AE Term: Flu-like illness (fever, chills, muscle aches, headache, fatigue, light headed), Onset Date: 05Feb2021, AE Outcome: Recovered, If recovered or recovered with sequelae Date of Recovery: 06Feb2021, Treatment: No. AE Term: COVID arm (redness, swelling, warmth, itching, pain at injection site; approx.2 inch diameter circle around site), Onset Date: 29Nov2022, AE Outcome: Recovering, Treatment: No. Comments/Narrative: COVID Shot 1: Received from [Hospital name withheld] as an employee. Felt no symptoms the day of, but almost exactly 18 hours later suffered from quick onset, intense diarrhea, extreme abdominal cramping, bloating, and gas for approx. 12 hours. Simethicone was taken but did not provide relief. COVID Shot 2: Again, received from [Hospital name withheld]. Felt no symptoms the day of, but almost exactly 18 hours later was hit with extreme muscle aches, chills, and light-headedness; unable to stand for more than a few seconds without the feeling of passing out; also had slight fever, all for approx. 12 hours. With both initial doses, the side effects were so bad I was unable to carry on daily tasks. First booster (third dose) was Moderna. Details not included above as this is not a Pfizer product. However, I experienced a similar reaction to COVID Shot 2, perhaps more intense. COVID Bivalent booster (fourth dose): Received by pharmacy technician at [Facility name withheld]. Felt no symptoms the day of. Next day experienced slight body aches and chills, but so mild compared to previous experiences that they felt mild and was able to continue daily activities. Second day post-shot, woke up feeling like I had a bruise on my arm at injection site; site was red, warm, swollen, hard, and painful. The redness expanded throughout the day; at its largest was approx. 2 inches in diameter. Ibuprofen taken twice to help with swelling and pain.; Sender's Comments: Linked Report(s) : US-PFIZER INC-PV202200115252 same patient, different vaccine doses.;US-PFIZER INC-202201344425 same patient, different vaccine doses/events;