Not sleeping as well; have soreness around the arm; Had significant chest pain in her left chest, lasted about a half hr, after 30 minutes it did go away.; the patient had a tired feeling/the patient walked 2 miles, which was out of context for her; heart was beating fast; This spontaneous case was reported by a patient and describes the occurrence of PALPITATIONS (heart was beating fast), INSOMNIA (Not sleeping as well), PAIN IN EXTREMITY (have soreness around the arm), CHEST PAIN (Had significant chest pain in her left chest, lasted about a half hr, after 30 minutes it did go away.) and FATIGUE (the patient had a tired feeling/the patient walked 2 miles, which was out of context for her) in an 83-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 prophylaxis.     No medical history information was reported.  Concomitant products included METOPROLOL for an unknown indication.    On 06-Oct-2022, the patient received fifth dose of mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (unknown route) 1 dosage form. On 07-Oct-2022, the patient experienced PALPITATIONS (heart was beating fast), CHEST PAIN (Had significant chest pain in her left chest, lasted about a half hr, after 30 minutes it did go away.) and FATIGUE (the patient had a tired feeling/the patient walked 2 miles, which was out of context for her). On 11-Oct-2022, the patient experienced INSOMNIA (Not sleeping as well) and PAIN IN EXTREMITY (have soreness around the arm). On 07-Oct-2022, CHEST PAIN (Had significant chest pain in her left chest, lasted about a half hr, after 30 minutes it did go away.) had resolved. At the time of the report, PALPITATIONS (heart was beating fast), INSOMNIA (Not sleeping as well), PAIN IN EXTREMITY (have soreness around the arm) and FATIGUE (the patient had a tired feeling/the patient walked 2 miles, which was out of context for her) outcome was unknown.            On 05-Feb-2021, the patient received the first dose of Moderna Covid-19 vaccine with Lot: 028L20A. On 05-Mar-2021, the patient received the second dose of Moderna Covid-19 vaccine with Lot: 04M20A. On 03-Nov-2021, the patient received the 1st booster dose of Moderna Covid-19 vaccine with Lot: 071F21A. On 21-Apr-2022, the patient received the 2nd booster dose of Moderna Covid-19 vaccine with Lot: 056M21A. The patient had a reaction and she thought it was to the bivalent booster. It was quite significant. On 06-Oct-2022, the patient got the Moderna Covid-19 vaccine, bivalent dose in her left arm. On 07-Oct-2022, she had significant chest pain in her left chest. It lasted about a half hr. After 30 minutes it did go away, it felt like a tired feeling. In a couple of hours, it came back, but not as strong and lasted about a half hr. Later that night, it felt like her heart was beating fast. On 08-Oct-2022, the patient spoke with her cardiologist. The cardiologist mentioned that she did not fit the profile. On 09-Oct-2022, she walked 2 miles, which was out of context for the patient. She was a little tired. She usually walked about 15 minutes 3 times/week. On 11-Oct-2022, she had soreness around the arm. She was also not sleeping as well. At the time of this report, the patient was going to see the cardiologist. The events did not get worse when the patient breathed in. No treatment details were reported.