Refridgeration excursions identified/ Vaccines stored in the refrigerator underwent several temperature excursions.; No adverse event; Refridgeration excursions identified/ Vaccines stored in the refrigerator underwent several temperature excursions.; This spontaneous case was reported by a nurse and describes the occurrence of PRODUCT TEMPERATURE EXCURSION ISSUE (Refridgeration excursions identified/ Vaccines stored in the refrigerator underwent several temperature excursions.), POOR QUALITY PRODUCT ADMINISTERED (Refridgeration excursions identified/ Vaccines stored in the refrigerator underwent several temperature excursions.) and NO ADVERSE EVENT (No adverse event) in a 38-year-old female patient who received mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (batch no. AS7146B) for COVID-19 prophylaxis.     It was unknown if patient had ever been diagnosed or tested positive for COVID-19.     On 20-Sep-2022 at 5:57 PM, the patient received fourth dose of mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (Intramuscular) .5 milliliter. On 20-Sep-2022 at 5:57 PM, the patient experienced POOR QUALITY PRODUCT ADMINISTERED (Refridgeration excursions identified/ Vaccines stored in the refrigerator underwent several temperature excursions.). On an unknown date, the patient experienced PRODUCT TEMPERATURE EXCURSION ISSUE (Refridgeration excursions identified/ Vaccines stored in the refrigerator underwent several temperature excursions.) and NO ADVERSE EVENT (No adverse event). At the time of the report, PRODUCT TEMPERATURE EXCURSION ISSUE (Refridgeration excursions identified/ Vaccines stored in the refrigerator underwent several temperature excursions.), POOR QUALITY PRODUCT ADMINISTERED (Refridgeration excursions identified/ Vaccines stored in the refrigerator underwent several temperature excursions.) and NO ADVERSE EVENT (No adverse event) outcome was unknown.        For mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (Intramuscular), the reporter considered NO ADVERSE EVENT (No adverse event) to be not related. No further causality assessments were provided for PRODUCT TEMPERATURE EXCURSION ISSUE (Refridgeration excursions identified/ Vaccines stored in the refrigerator underwent several temperature excursions.) and POOR QUALITY PRODUCT ADMINISTERED (Refridgeration excursions identified/ Vaccines stored in the refrigerator underwent several temperature excursions.).    Concomitant medications were not provided.  The patient received first three doses of Moderna COVID-19 Vaccine via Intramuscular route on deltoid.  Dose 4 vaccine was administered at deltoid region.  It was reported that refrigeration excursions identified, state vaccine was housed in these units. There were excursions noted. Manufactures were notified and the state department and made aware of the situation.The nurse called for a clinic that she was assisting. The clinic had a similar issue with vaccines stored in their freezer. Bivalent vaccines stored in the refrigerator that underwent several temperature excursions going back to August 2022.  Treatment medications were not provided.