was boosted and vaccinated, tested positive for Covid; This spontaneous case was reported by a patient and describes the occurrence of COVID-19 (was boosted and vaccinated, tested positive for Covid) in a 48-year-old female patient who received mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) for COVID-19 prophylaxis.     Patient had 3.8 years of sobriety.  The patient's past medical history included Methicillin-resistant Staphylococcus aureus infection (Had MRSA in her blood stream in 2017 and has not gone back to that doctor.) in 2017 and Endocarditis (Probably has endocarditis and hasn't taken care of it.). Concurrent medical conditions included Neuropathy (probably worst one) and Fibromyalgia. Concomitant products included METHADONE for an unknown indication.    On an unknown date, 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 12-Oct-2022, the patient experienced COVID-19 (was boosted and vaccinated, tested positive for Covid). The patient was treated with NIRMATRELVIR, RITONAVIR (PAXLOVID) from 13-Oct-2022 to 18-Oct-2022 for COVID-19 treatment, at a dose of Blue Foil packet, 6 in each one, morning dose, night dose each with 2 white pill, 1 pink pill. At the time of the report, COVID-19 (was boosted and vaccinated, tested positive for Covid) outcome was unknown.      DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 12-Oct-2022, SARS-CoV-2 test: (Positive) That first night took the test that came back as positive.         Patient ethnicity was reported as other. It was clarified that patient was vaccinated and boosted prior to testing positive for COVID-19 and clarified that patient had the Moderna COVID vaccines and booster.Patient had horrible metallic taste, started literally 30 minutes after the first pill of Paxlovid. Was not still experiencing it now, strong metal taste lasted about 4 hours after each pill. Was also drinking a lot of herbal teas and dose not know if that affected it. It would completely fade away after that and probably lasted like 8 hours each time. It had not tasted right any by the time patient would take the next pill, could have been getting used to it. On the 4th day of taking the Paxlovid, started taking Mucinex, from 16-Oct-2022 to 19-Oct-2022, batch lot number MK584, expiry (Jan-2025), 600 mg Guaifenesin extended release Bilayer tablet for chest congestion (had mucous which was very gross and was still coughing up a lot of stuff) and the next day, the 5th day, started with the serotonin syndrome (self diagnosed) feelings and does not know if blood pressure went up but, was sweating like crazy (clothes soaked through), was really tired, freezing and had cold sweats, total 100 percent restless leg big time, heart palpitations, thinks this was more from the Mucinex. Stopped taking it because when patient looked it up, saw that, when mixed with other medications, could cause serotonin syndrome. Could have gone into seizures if had not stopped. Thinks it was just a drug reaction caused by the Mucinex with other medications, not caused by the Pfizer medication. Patient was going for blood work next week and tomorrow, was getting drug tested.