Swollen painful lymph nodes - both under-arms and neck; Swollen painful lymph nodes - both under-arms and neck; lower back pain; joint pain; Other vaccine same date product: Flu, Other vaccine same date vaccine date: 21Oct2022; Other vaccine same date product: Flu, Other vaccine same date vaccine date: 21Oct2022; This is a spontaneous report received from a contactable reporter(s) (Consumer or other non HCP). The reporter is the patient.  A 53-year-old female patient (not pregnant) received BNT162b2, BNT162b2 omi ba.4-5 (BNT162B2, BNT162B2 OMI BA.4-5), on 21Oct2022 at 19:00 as dose 4 (booster), single (Lot number: GJ6665) at the age of 53 years, in left arm for covid-19 immunisation; influenza vaccine (FLU VACCINE VII), on 21Oct2022 as dose 1, single (Batch/Lot number: unknown), in left arm. The patient's relevant medical history included: "Heart palpitations (SVT)" (unspecified if ongoing); "Heart palpitations (SVT)" (unspecified if ongoing); "Allergy to shellfish" (unspecified if ongoing). Concomitant medication(s) included: PROPRANOLOL; NAPROXEN; AMBEREN; BIOTIN. Vaccination history included: BNT162b2 (Dose 1 Single, Batch/Lot No: EW0150, Location of injection: Arm Left), administration date: 10Apr2021, when the patient was 52-year-old, for COVID-19 immunization, reaction(s): "The morning after: some joint pain, severe pain in spine but only lasted a couple of hours", "The morning after: some joint pain, severe pain in spine but only lasted a couple of hours", "About 24 hours after shot: swollen hands and feet but was gone by the second morning", "About 48 hours after shot: sore, swollen lymph nodes, also stabbing pains in the lymph nodes (neck, armpits, left side of chest and groin)", "About 48 hours after shot: sore, swollen lymph nodes, also stabbing pains in the lymph nodes (neck, armpits, left side of chest and groin)"; BNT162b2 (Dose 2 Single, Batch/Lot No: EW0170, Location of injection: Arm Left), administration date: 02May2021, when the patient was 52-year-old, for COVID-19 immunization, reaction(s): "swollen lymph nodes"; BNT162b2 (Dose 3 Single, Batch/Lot No: FJ8762, Location of injection: Arm Left), administration date: 08Dec2021, when the patient was 52-year-old, for COVID-19 immunization, reaction(s): "lymph nodes were swollen". The following information was reported: OFF LABEL USE (non-serious), PRODUCT USE ISSUE (non-serious) all with onset 21Oct2022, outcome "unknown" and all described as "Other vaccine same date product: Flu, Other vaccine same date vaccine date: 21Oct2022"; LYMPHADENOPATHY (non-serious), LYMPH NODE PAIN (non-serious) all with onset 22Oct2022 at 17:30, outcome "recovering" and all described as "Swollen painful lymph nodes - both under-arms and neck"; ARTHRALGIA (non-serious) with onset 22Oct2022 at 17:30, outcome "recovering", described as "joint pain"; BACK PAIN (non-serious) with onset 22Oct2022 at 17:30, outcome "recovering", described as "lower back pain". Therapeutic measures were not taken as a result of lymphadenopathy, lymph node pain, back pain, arthralgia.  Additional information: The patient did not know the lot number of other vaccine given on same date. The patient did not receive other vaccine in four weeks. The patient was not diagnosed with covid prior to vaccination. The patient was not tested for covid post vaccination. Adverse event: Swollen painful lymph nodes-both under-arms and neck, lower back pain, joint pain. For the first 2 shots the swollen lymph nodes lasted 3 weeks but almost all lymph nodes were swollen for the first few days, then only my neck and left underarm. The 3rd shot, the lymph nodes were swollen for less than a week.