They had Moderna vial that was out of the fridge between 20 to 24 hours and the vial was already punctured and a dose was given from this vial/ approximately 25 hours/ vaccine was out for 27 hours; No adverse reaction; They had Moderna vial that was out of the fridge between 20 to 24 hours and the vial was already punctured and a dose was given from this vial/ approximately 25 hours/ vaccine was out for 27 hours; This spontaneous case was reported by an other health care professional and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (They had Moderna vial that was out of the fridge between 20 to 24 hours and the vial was already punctured and a dose was given from this vial/ approximately 25 hours/ vaccine was out for 27 hours), PRODUCT STORAGE ERROR (They had Moderna vial that was out of the fridge between 20 to 24 hours and the vial was already punctured and a dose was given from this vial/ approximately 25 hours/ vaccine was out for 27 hours) and NO ADVERSE EVENT (No adverse reaction) in a  patient of an unknown age and gender who received mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (batch no. AS7170B) for COVID-19 prophylaxis.     No Medical History information was reported.    On 11-Jan-2023, the patient received dose of mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (unknown route) 1 dosage form. On 11-Jan-2023,  after starting mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)), the patient experienced EXPIRED PRODUCT ADMINISTERED (They had Moderna vial that was out of the fridge between 20 to 24 hours and the vial was already punctured and a dose was given from this vial/ approximately 25 hours/ vaccine was out for 27 hours). On an unknown date, the patient experienced PRODUCT STORAGE ERROR (They had Moderna vial that was out of the fridge between 20 to 24 hours and the vial was already punctured and a dose was given from this vial/ approximately 25 hours/ vaccine was out for 27 hours) and NO ADVERSE EVENT (No adverse reaction). At the time of the report, EXPIRED PRODUCT ADMINISTERED (They had Moderna vial that was out of the fridge between 20 to 24 hours and the vial was already punctured and a dose was given from this vial/ approximately 25 hours/ vaccine was out for 27 hours), PRODUCT STORAGE ERROR (They had Moderna vial that was out of the fridge between 20 to 24 hours and the vial was already punctured and a dose was given from this vial/ approximately 25 hours/ vaccine was out for 27 hours) and NO ADVERSE EVENT (No adverse reaction) outcome was unknown.        For mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (Unknown), the reporter considered NO ADVERSE EVENT (No adverse reaction) to be not related. No further causality assessments were provided for EXPIRED PRODUCT ADMINISTERED (They had Moderna vial that was out of the fridge between 20 to 24 hours and the vial was already punctured and a dose was given from this vial/ approximately 25 hours/ vaccine was out for 27 hours) and PRODUCT STORAGE ERROR (They had Moderna vial that was out of the fridge between 20 to 24 hours and the vial was already punctured and a dose was given from this vial/ approximately 25 hours/ vaccine was out for 27 hours).    No concomitant medications were reported.  The patient receives any other vaccines in the 4 weeks prior to COVID-19 vaccine reported as unknown.  Date the vial was initially stored in the refrigerator was 06 Jan 2023 6. The vial was first punctured on 10 Jan 2023 around 12:00PM to 1:00PM. Vaccine was administered on 11 Jan 2023 around 2:00 PM. The vial haven't undergone any temperature excursions.   No treatment medications were reported.   Most recent FOLLOW-UP information incorporated above includes: On 12-Jan-2023: The recent follow-up contains significant information as narrative updated.