woke up at 1 AM with muscle aches/really bad muscle pain in my lower back worse than he normally feels it; aches and pains in my joints/pain in my shoulder and my arm; he had chills, but he wasn't shivering but felt cold.; fatigue/a little tired/a little bit washed out; arm and shoulder were throbbing; arm started to hurt really bad; more side effects; Urinary frequency; This spontaneous case was reported by a patient and describes the occurrence of IMMUNISATION REACTION (more side effects), POLLAKIURIA (Urinary frequency), PAIN (arm and shoulder were throbbing), PAIN IN EXTREMITY (arm started to hurt really bad) and MYALGIA (woke up at 1 AM with muscle aches/really bad muscle pain in my lower back worse than he normally feels it) in a male patient of an unknown age who received mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below.     No Medical History information was reported.    On 15-Sep-2022 at 1:00 PM, the patient received fifth dose of mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (unknown route) 1 dosage form. On 15-Sep-2022, the patient experienced IMMUNISATION REACTION (more side effects), POLLAKIURIA (Urinary frequency) and PAIN IN EXTREMITY (arm started to hurt really bad). On 16-Sep-2022, the patient experienced PAIN (arm and shoulder were throbbing), ARTHRALGIA (aches and pains in my joints/pain in my shoulder and my arm), CHILLS (he had chills, but he wasn't shivering but felt cold.) and FATIGUE (fatigue/a little tired/a little bit washed out). On 16-Sep-2022 at 1:00 AM, the patient experienced MYALGIA (woke up at 1 AM with muscle aches/really bad muscle pain in my lower back worse than he normally feels it). The patient was treated with PARACETAMOL (TYLENOL) on 16-Sep-2022 at a dose of UNK (about 1:30 AM). At the time of the report, IMMUNISATION REACTION (more side effects) outcome was unknown, POLLAKIURIA (Urinary frequency), MYALGIA (woke up at 1 AM with muscle aches/really bad muscle pain in my lower back worse than he normally feels it), CHILLS (he had chills, but he wasn't shivering but felt cold.) and FATIGUE (fatigue/a little tired/a little bit washed out) was resolving and PAIN (arm and shoulder were throbbing), PAIN IN EXTREMITY (arm started to hurt really bad) and ARTHRALGIA (aches and pains in my joints/pain in my shoulder and my arm) had not resolved.      DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 16-Sep-2022, Body temperature: 97.5 (no fever at all).         No concomitant medication was reported. Patient received 5 Moderna doses. Patient had been a biology teacher for many, many years. Patient took the bivalent shot at 1 o clock in the afternoon, and felt fine. Around 9-10 o clock, his arm started to hurt really bad. Patient did drink a lot of water because the guidelines said to hydrate. Patient states it was a little strange. Patient took Tylenol at about 1:30 AM then went back to sleep and didn't have to get up to urinate. Today patient was feeling better. The patient explains that he had lower back issues to begin with. The illness always affects his weak spot. Patient still has pain in his shoulder and his arm. Patient felt better now than patient did this morning 16Sep2022.   This case was linked to MOD-2022-647146, MOD-2021-015968 (Patient Link).