she felt she had a sore arm; chest, back,knees, elbows, and the rest of her body that was red; chest,back, knees, elbows, and the rest of her body that was hot; chest,back, knees, elbows, and the rest of her body that was itchy; she had flu like symptoms for 24 hours; She has taken some antihistamines to help with her sleep, however not much; rash on her chest, back, knees, elbows, and the rest of her body; This spontaneous case was reported by a patient and describes the occurrence of PAIN IN EXTREMITY (she felt she had a sore arm), ERYTHEMA (chest, back,knees, elbows, and the rest of her body that was red), FEELING HOT (chest,back, knees, elbows, and the rest of her body that was hot), PRURITUS (chest,back, knees, elbows, and the rest of her body that was itchy) and INFLUENZA LIKE ILLNESS (she had flu like symptoms for 24 hours) in a 65-year-old female patient who received mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (batch no. 80777-0282-75) for COVID-19 prophylaxis. The occurrence of additional non-serious events is detailed below.     The patient's past medical history included Shingles. Concurrent medical conditions included Chemical sensitivity (patient take injectable glutathione for her chemical sensitivities.).  On 15-Sep-2022, the patient received fourth dose of mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (Intramuscular) 1 dosage form. In 2022, the patient experienced PAIN IN EXTREMITY (she felt she had a sore arm), ERYTHEMA (chest, back,knees, elbows, and the rest of her body that was red), FEELING HOT (chest,back, knees, elbows, and the rest of her body that was hot), PRURITUS (chest,back, knees, elbows, and the rest of her body that was itchy), INFLUENZA LIKE ILLNESS (she had flu like symptoms for 24 hours), SLEEP DISORDER (She has taken some antihistamines to help with her sleep, however not much) and RASH (rash on her chest, back, knees, elbows, and the rest of her body). In 2022, INFLUENZA LIKE ILLNESS (she had flu like symptoms for 24 hours) had resolved. At the time of the report, PAIN IN EXTREMITY (she felt she had a sore arm), ERYTHEMA (chest, back,knees, elbows, and the rest of her body that was red), FEELING HOT (chest,back, knees, elbows, and the rest of her body that was hot), PRURITUS (chest,back, knees, elbows, and the rest of her body that was itchy), SLEEP DISORDER (She has taken some antihistamines to help with her sleep, however not much) and RASH (rash on her chest, back, knees, elbows, and the rest of her body) outcome was unknown.      No concomitant medications were reported.  Patient had received 4 doses of the Moderna COVID-19 vaccines by intramuscular injection on 2APR2021 (lot number 031A21A), 3MAY2021 (lot number 027B21A), 19OCT2021 (lot number 014F21A).  It was reported that, following her most recent dose, patient had a sore arm, but it was less. and she had flu like symptoms for 24 hours. After the flu like symptoms, she experienced a rash on her chest, back, knees, elbows, and the rest of her body that was red, itchy, hot, and felt like in her nerves rather than her skin. Patient states It was similar to her past shingles in feeling, but all over her body. Patient has taken some antihistamines to help with her sleep, however not much. Patient took injectable glutathione. Patient has also talked to her doctor who gave her some suggestions on how to tamp it down.   This case was linked to MOD-2022-654683 (Patient Link).