soreness in the injection site; that she also has hemolytic anemia, which makes her lethargic or weak sometimes but not severely. She thinks something pushed her hematocrit and hemoglobin in the normal range/sense of real well-being/felt very good; This spontaneous case was reported by a patient and describes the occurrence of VACCINATION SITE PAIN (soreness in the injection site) and THERAPEUTIC RESPONSE UNEXPECTED (that she also has hemolytic anemia, which makes her lethargic or weak sometimes but not severely. She thinks something pushed her hematocrit and hemoglobin in the normal range/sense of real well-being/felt very good) in an 82-year-old female patient who received mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (batch nos. AS7642B and 057F22A) for COVID-19 prophylaxis.     Question:Describe relevant medical history/conditions, allergy, concomitant diseases and risk factor.Answer:Hemolytic anemia. Mild hypertension. Mild COPD with no treatment.  Concurrent medical conditions included Hemolytic anemia (The patient states her age and reports that she also had hemolytic anemia, which makes her lethargic or weak sometimes but not severely), Hypertension and COPD (with no treatment). Concomitant products included LOSARTAN and AMLODIPINE for an unknown indication.   On 07-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 30-May-2023, received sixth dose of mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient experienced VACCINATION SITE PAIN (soreness in the injection site) and THERAPEUTIC RESPONSE UNEXPECTED (that she also has hemolytic anemia, which makes her lethargic or weak sometimes but not severely. She thinks something pushed her hematocrit and hemoglobin in the normal range/sense of real well-being/felt very good). At the time of the report, VACCINATION SITE PAIN (soreness in the injection site) and THERAPEUTIC RESPONSE UNEXPECTED (that she also has hemolytic anemia, which makes her lethargic or weak sometimes but not severely. She thinks something pushed her hematocrit and hemoglobin in the normal range/sense of real well-being/felt very good) outcome was unknown.      DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Haematocrit: Normal. On an unknown date, Haemoglobin: Normal.  Patient did not received any other vaccine 4 weeks prior to covid-19.  On 20-Jan-2021 patient received 1st monovalent dose of Moderna Covid-19 vaccine (batch number was not reported). On 17-Feb-2021 patient received 2nd monovalent dose of Moderna Covid-19 vaccine (batch number was not reported). On 03-Nov-2021 patient received 3rd dose of Moderna Covid-19 vaccine (batch number: 939905).  On 08-May-2022 patient received 4th dose of Moderna Covid-19 vaccine (batch number: 004M2M).  Patient had both of the COVID19 bivalent booster shots. On each shot, she had what she considered a positive reaction, especially the one she took just last week. She had no negative reactions at all. Within 2-3 hours, she experienced a sense of real well-being. She could not describe it any other way. She never felt anything quite like it before. She remembers experiencing it when she took the booster last October. She felt very good after having a booster shot with no negative side effects. In addition to wanting to report that, she was hoping that there might be some information about what particular ingredient, what part of the formulation could it possibly trigger a sense of well-being in the absence of any negative adverse effects. All she had was soreness in the injection site. The patient reports that she felt the positive effects about 2-3 hours after receiving the bivalent vaccine last week. The patient states her age and reports that she also had hemolytic anemia, which makes her lethargic or weak sometimes but not severely. She thinks something pushed her hematocrit and hemoglobin in the normal range. She thinks her sense of well-being (after taking the vaccine) gave her energy. She really felt very good. She thinks something in the vaccine triggered a positive reaction. She was taking losartan and amlodipine as needed. She asked her primary care physician, but he didn't had a theory about what might have happened. This was her own hypothesis or theory. It lasted for about 3 days, then it began to wane a little bit. She could still feel some difference in her body. She was out to dinner last night 4-Jun-2023 and her friend told her that she seemed chipper, energetic, like she was feeling good. She was not feeling at the level that she felt after the booster. The patient reports that she took her two bivalent shots at the same facility.  Treatment information was not provided.