feels over all unstable; itching from her ankle up; extremely fatigued; extremely fatigued that it is taking her ability to function; She was flushing; would wake up with the sensation of rushing through her outer extremities; run a fever of 160-200; This spontaneous case was reported by a patient and describes the occurrence of FLUSHING (She was flushing), DISCOMFORT (would wake up with the sensation of rushing through her outer extremities), FEELING ABNORMAL (feels over all unstable), PRURITUS (itching from her ankle up) and FATIGUE (extremely fatigued) in a 91-year-old female patient who received mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (batch no. AS7163B) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below.     No medical history was provided by the reporter.  The patient's past medical history included Angiogram coronary (4 years ago) and Stent insertion NOS (6 heart stents). Previously administered products included for Product used for unknown indication: flu vaccine in September 2021. Past adverse reactions to the above products included No adverse event with flu vaccine. Concurrent medical conditions included Hypertension, Endometrial cancer and Thyroid cancer. Concomitant products included ACETYLSALICYLIC ACID (BABY ASPIRIN), HYDROCHLOROTHIAZIDE, ATORVASTATIN, ISOSORBIDE and LEVOTHYROXINE SODIUM (UNITHROID) for an unknown indication.    On 27-Sep-2022, the patient received fourth dose of mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (unknown route) 1 dosage form. On 27-Sep-2022, the patient experienced FLUSHING (She was flushing), DISCOMFORT (would wake up with the sensation of rushing through her outer extremities) and PYREXIA (run a fever of 160-200). On an unknown date, the patient experienced FEELING ABNORMAL (feels over all unstable), PRURITUS (itching from her ankle up), FATIGUE (extremely fatigued) and LOSS OF PERSONAL INDEPENDENCE IN DAILY ACTIVITIES (extremely fatigued that it is taking her ability to function). The patient was treated with PREDNISONE from 29-Sep-2022 to 03-Oct-2022 at an unspecified dose and frequency and CORTISONE for Itching, at an unspecified dose and frequency. At the time of the report, FLUSHING (She was flushing), DISCOMFORT (would wake up with the sensation of rushing through her outer extremities), FEELING ABNORMAL (feels over all unstable), PRURITUS (itching from her ankle up), FATIGUE (extremely fatigued), PYREXIA (run a fever of 160-200) and LOSS OF PERSONAL INDEPENDENCE IN DAILY ACTIVITIES (extremely fatigued that it is taking her ability to function) had not resolved.      DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 27-Sep-2022, Body temperature: 160-200.         It was reported that the patient had no allergies and COVID positive test in the past.  It was reported that patient had problems with the thyroid medications. It was reported that patient took First dose of Moderna vaccine on 25-Feb-2021 (Lot number: 030M20A), second dose of Moderna vaccine on 25-Mar-2021 (Lot number: 031A21A) and third dose of Moderna vaccine (Booster 1) on 19-Nov-2021 (Lot number: 039F21A).  The patient thought that maybe the vaccine and the thyroid medications are interacting or maybe she was just too old.   This case was linked to MOD-2022-655153 (Patient Link).