COVID vaccination has begun in most of the countries. Older population and high-risk groups are prioritized for vaccination. Postvaccination imaging in cancer patients may show effects of the immune response to the vaccine. As such, it is important to know the timing and laterality of the vaccination as the reactive lymph nodes in the ipsilateral axilla can be seen on the imaging. We present a case of DOTATATE-avid nonpathologically enlarged lymph nodes in ipsilateral axilla and linear tracer uptake in the deltoid muscle on a patient imaged for a recent diagnosis of rectal neuroendocrine neoplasm.