Redness at the injection site; Injection site was red and tender,the swelling moved 2 inches down the arm; big lymph was swollen large area measuring 2 inches wide, 4 inches long and 1 inch deep it is located under armpit it looked like  bar of soap; Itchiness at the injection site; Swelling at the injection site; This spontaneous case was reported by a patient and describes the occurrence of VACCINATION SITE LYMPHADENOPATHY (big lymph was swollen large area measuring 2 inches wide, 4 inches long and 1 inch deep it is located under armpit it looked like  bar of soap), VACCINATION SITE PRURITUS (Itchiness at the injection site), VACCINATION SITE SWELLING (Swelling at the injection site), VACCINATION SITE ERYTHEMA (Redness at the injection site) and VACCINATION SITE PAIN (Injection site was red and tender,the swelling moved 2 inches down the arm) in a 66-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 014B22A, 004F21A, 014M20A and 012M20A) for COVID-19 vaccination.     Concurrent medical conditions included Acid reflux (esophageal) (Acid reflux), Restless leg syndrome, Hashimoto's thyroiditis, Blood pressure high (High blood pressure), Drug allergy (Sulfa drugs), Iodine contrast media allergy (iodine contrast) and Seasonal allergy. Concomitant products included OMEPRAZOLE for Acid reflux (esophageal), HYDROCHLOROTHIAZID for Blood pressure high, LEVOTHYROXINE SODIUM (SYNTHROID) and LIOTHYRONINE SODIUM (CYTOMEL) for Hashimoto's thyroiditis, PRAMIPEXOLE DIHYDROCHLORIDE MONOHYDRATE (MIRAPEX) for Restless leg syndrome.   On 27-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) .5 milliliter. On 24-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to .5 milliliter. On 05-Nov-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to .25 milliliter. On 28-Jun-2022, received fourth dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to .25 milliliter. In June 2022, the patient experienced VACCINATION SITE LYMPHADENOPATHY (big lymph was swollen large area measuring 2 inches wide, 4 inches long and 1 inch deep it is located under armpit it looked like  bar of soap), VACCINATION SITE PRURITUS (Itchiness at the injection site) and VACCINATION SITE SWELLING (Swelling at the injection site). On 29-Jun-2022,  after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced VACCINATION SITE ERYTHEMA (Redness at the injection site) and VACCINATION SITE PAIN (Injection site was red and tender,the swelling moved 2 inches down the arm). The patient was treated with PARACETAMOL (TYLENOL) at an unspecified dose and frequency. At the time of the report, VACCINATION SITE LYMPHADENOPATHY (big lymph was swollen large area measuring 2 inches wide, 4 inches long and 1 inch deep it is located under armpit it looked like  bar of soap), VACCINATION SITE PRURITUS (Itchiness at the injection site), VACCINATION SITE SWELLING (Swelling at the injection site), VACCINATION SITE ERYTHEMA (Redness at the injection site) and VACCINATION SITE PAIN (Injection site was red and tender,the swelling moved 2 inches down the arm) had not resolved.            The Patient was never tested or had diagnosed with COVID-19.  The Patient stated that on 29Jun2022 injection site was red, and tender What surprised her was that it has now left injection site, now it is on bottom part of the patient arm, between triceps and biceps On 30June2022,it was still tender, by yesterday evening, the redness, tenderness and swelling moved 2 inches down patients arm. When she felt the tenderness under her arms, she went to palpate it and was amazed that it was a large area measuring 2 inches wide, 4 inches long and 1 inch deep(when she grabbed it). It is located under left arm pit. Patient expressed how surprised was to see how big lymph was swollen, it looked like a bar of soap.   This case was linked to MOD-2022-598147, MOD-2022-598177 (Patient Link).