blood pressure would go up into the 200's; nightmares; sleepy; sore arm; dreaming; Head felt so strange; felt hungry, like her sugar was low; her pulse was 70. Caller states that is a little high for her, her pulse is usually 65; lot of hunger; brain fog; feel tired; muscle pains; feeling unwell; pain on the back of her neck; feel depressed; anxiety/feeling angsty; depression; crying; got a bruise; nervous; nauseous/nausea; flu; 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 81-year-old female patient received BNT162b2, BNT162b2 omi ba.4-5 (BNT162B2, BNT162B2 OMI BA.4-5), on 09Oct2022 as dose 4 (booster), 0.3 ml single (Lot number: GH9693) at the age of 81 years, in left arm for covid-19 immunisation. The patient's relevant medical history included: "Nightmares" (unspecified if ongoing); "Blood pressure" (unspecified if ongoing); "Anxiety" (unspecified if ongoing). Concomitant medication(s) included: AMLODIPINE BESYLATE taken for blood pressure measurement (ongoing); CLONAZEPAM taken for anxiety, start date: 2016 (ongoing). Vaccination history included: BNT162b2 (First Dose of the Pfizer Covid Vaccine: Received by the caller on 23Jan2021; Lot Number: EL9262; Administered in the caller's left arm.), administration date: 23Jan2021, when the patient was 79-year-old, for COVID-19 Immunization; BNT162b2 (Second Dose of the Pfizer Covid Vaccine: Received by the caller on 13 Feb 2021; Lot Number: EL9266; Administered in the caller's left arm.), administration date: 13Feb2021, when the patient was 79-year-old, for COVID-19 Immunization; BNT162b2 (Third Dose/First Booster Dose of the Pfizer Covid Vaccine: Received by the caller on 13 Oct 2021; Lot Number: EW0177; Administered in the caller's left arm.), administration date: 13Oct2021, when the patient was 80-year-old, for COVID-19 Immunization; Bnt162b2, for COVID-19 Immunization. The following information was reported: FATIGUE (non-serious) with onset 10Oct2022, outcome "unknown", described as "feel tired"; MYALGIA (non-serious) with onset 10Oct2022, outcome "unknown", described as "muscle pains"; ANXIETY (non-serious) with onset Oct2022, outcome "unknown", described as "anxiety/feeling angsty "; CRYING (non-serious) with onset Oct2022, outcome "unknown"; DEPRESSION (non-serious) with onset Oct2022, outcome "unknown"; DEPRESSED MOOD (non-serious) with onset Oct2022, outcome "unknown", described as "feel depressed"; MALAISE (non-serious) with onset Oct2022, outcome "unknown", described as "feeling unwell"; INFLUENZA (non-serious) with onset Oct2022, outcome "unknown", described as "flu"; CONTUSION (non-serious) with onset Oct2022, outcome "not recovered", described as "got a bruise"; NAUSEA (non-serious) with onset Oct2022, outcome "unknown", described as "nauseous/nausea"; NERVOUSNESS (non-serious) with onset Oct2022, outcome "unknown", described as "nervous"; NECK PAIN (non-serious) with onset Oct2022, outcome "unknown", described as "pain on the back of her neck"; FEELING ABNORMAL (non-serious) with onset 16Oct2022, outcome "unknown", described as "brain fog"; BLOOD GLUCOSE DECREASED (non-serious) with onset 16Oct2022, outcome "unknown", described as "felt hungry, like her sugar was low"; HEART RATE INCREASED (non-serious) with onset 16Oct2022, outcome "unknown", described as "her pulse was 70. Caller states that is a little high for her, her pulse is usually 65"; HUNGER (non-serious) with onset 16Oct2022, outcome "unknown", described as "lot of hunger"; FEELING ABNORMAL (non-serious) with onset 17Oct2022, outcome "unknown", described as "Head felt so strange"; BLOOD PRESSURE INCREASED (medically significant), outcome "unknown", described as "blood pressure would go up into the 200's"; NIGHTMARE (non-serious), outcome "unknown", described as "nightmares"; SOMNOLENCE (non-serious), outcome "unknown", described as "sleepy"; PAIN IN EXTREMITY (non-serious), outcome "unknown", described as "sore arm"; ABNORMAL DREAMS (non-serious), outcome "unknown", described as "dreaming". The event "blood pressure would go up into the 200's" required emergency room visit. The patient underwent the following laboratory tests and procedures: Blood pressure measurement: (unspecified date) 200, notes: blood pressure would go up into the 200's; (16Oct2022) 128/64, notes: Result: 128/64; Unit: Not Provided; Echocardiogram: (unspecified date) Perfect, notes: Result: Perfect; Unit: Not Provided; Heart rate: (16Oct2022) 70, notes: Result: 70; Unit: Not Provided.  Clinical course: Caller stated that all of her events have been going on since last week. Stated that she was doing better today. Caller stated that she woke up this morning and was scared if she was okay. Her husband passed away three years ago, and the caller would have nightmares and her blood pressure would go up into the 200's and she would end up going to the Emergency Room via ambulance. Caller stated that because of that the doctor put her on the Clonazepam for anxiety in 2016. Caller stated that was right before her husband passed away. Caller said that her husband had been in the ICU for 13 days and was coming home. The caller was having nightmares afraid that she would not take good care of her husband while he was home and that he would die. Her cardiologist told her to keep taking the anxiety and blood pressure medication to make sure that her blood pressure is low so that if she again has a nightmare, it will be okay. Caller states that she sleeps well, 9 or more hours, but she was always dreaming.