he is extremely fatigued; has a very sore arm at the injection site; has a very sore arm at the injection site; he is so weak his wife had to pick him up and put him into bed; had 4th dose; This is a spontaneous report received from a contactable reporter(s) (Consumer or other non HCP) from medical information team for a Pfizer sponsored program (159558).  A male patient received bnt162b2 (BNT162B2, Solution for injection), administration date 14Feb2022 (Batch/Lot number: unknown) as dose 4 (booster), single for covid-19 immunisation. Relevant medical history included: "blood cancer" (unspecified if ongoing). The patient's concomitant medications were not reported. Vaccination history included: Bnt162b2 (Dose 1), for Covid-19 immunization; Bnt162b2 (Dose 2), for Covid-19 immunization; Bnt162b2 (Dose 3 (Booster)), for Covid-19 immunization. The following information was reported: OFF LABEL USE (non-serious) with onset 14Feb2022, outcome "unknown", described as "had 4th dose"; FATIGUE (non-serious), outcome "unknown", described as "he is extremely fatigued"; VACCINATION SITE PAIN (non-serious), PAIN IN EXTREMITY (non-serious), outcome "unknown" and all described as "has a very sore arm at the injection site"; ASTHENIA (non-serious), outcome "unknown", described as "he is so weak his wife had to pick him up and put him into bed".  Additional information: Reporter's friend has blood cancer and had 4th dose (booster for immunocompromised) of the PBCV on Monday, 14Feb2022, following "an infusion of some kind on Friday, 11Feb2022. Since receiving the booster dose, he was extremely fatigued, had a very sore arm at the injection site and "he was so weak his wife had to pick him up and put him into bed" Is this part of the normal side effects. Have you had other reports of immunocompromised patients having these symptoms. Should they be seeking out other treatment or is this normal. Those of us who have had the vaccines know about a sore arm and fatigue, but his was worse. Reaction/event as reported by primary source a lot of pain at the injection site, extreme fatigue. The patient was not the reporter. The dates for a lot of pain at the injection site and extreme fatigue were from unspecified to unspecified. It was unspecified that Covid-19 vaccine was a Pfizer product. Covid-19 Vaccine manufacturer was unspecified. The dates for Covid-19 Vaccine were from unspecified to unspecified. NDC number of Covid-19 Vaccine was not provided. The reason for no lot number of Covid-19 Vaccine was reported as reporter unwilling to complete the report. The expiry date of Covid-19 Vaccine was not provided. Other Products were not provided. The investigation assessment was not provided. The transferring agent stated that he has a reporter on the line that was calling about her friend and mentioned that he had cancer of the blood and he had his 4th dose of the Covid-19 vaccine. The reporter reported that her friend is having extreme fatigue and he was going to had a infusion on Friday. The transferring agent did not collect any of the reporter's contact details before transferring the reporter. The reporter verified the information provided by the transferring agent and clarified that her friend had a infusion on Friday. She said that her friend had cancer of the blood and had a infusion on Friday. He had his 4th Pfizer Covid-19 dose on Monday. The patient has a lot of pain at the injection site and he has extreme fatigue. She knows people can get fever, chills, and fatigue after the vaccine, but she wanted to know if what was going on with her friend was normal. Caller clarified that her friend had cancer of the blood was prior to receiving the Covid-19 vaccines. Reporter declined to complete a report and requested to be transferred  to had her questions addressed. No further details provided.   The lot number for the vaccine, [BNT162B2] was not provided and will be requested during follow-up.