still got COVID. Then got Rebound COVID/falling asleep in chair and not wanting to eat; not been eating that much since this all this started in Oct-2022; the brain deterioration issue and that was prior to Paxlovid; This spontaneous case was reported by a patient family member or friend and describes the occurrence of COVID-19 (still got COVID. Then got Rebound COVID/falling asleep in chair and not wanting to eat), HYPOPHAGIA (not been eating that much since this all this started in Oct-2022) and NEUROLOGICAL DECOMPENSATION (the brain deterioration issue and that was prior to Paxlovid) in a 73-year-old male patient who received mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (batch no. 057FZZA or 22A) for Prevention.    Co-suspect product included non-company product NIRMATRELVIR, RITONAVIR (PAXLOVID) for COVID-19 prophylaxis.    This summer having problems again and tired again and went to Cardiologist and said it was 50 percent blockage. Just had it cleared in Dec, but did test and did not find out anything else.  The patient's past medical history included Stroke in March 2020, Carotid artery occlusion, Neurodegenerative disorder and Surgery (When they did the test, they found the right side was 100 percent blocked and monitoring the left one. Left one started building up and got to 65 percent and jumped up to 75 percent and had surgery on that Dec 2021.) in December 2021. Concurrent medical conditions included Seizures and Disability (He was disabled and was finding out what his medications were on, He was disabled prior to taking Paxlovid). Concomitant products included CARBAMAZEPINE for Seizures.   On 10-Oct-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 22-Oct-2022, the patient started NIRMATRELVIR, RITONAVIR (PAXLOVID) (Oral) 3 pills twice daily by mouth.. In 2022, the patient experienced NEUROLOGICAL DECOMPENSATION (the brain deterioration issue and that was prior to Paxlovid). In October 2022, the patient experienced HYPOPHAGIA (not been eating that much since this all this started in Oct-2022). On 27-Nov-2022, the patient experienced COVID-19 (still got COVID. Then got Rebound COVID/falling asleep in chair and not wanting to eat). The patient was treated with PARACETAMOL (TYLENOL) at an unspecified dose and frequency. At the time of the report, COVID-19 (still got COVID. Then got Rebound COVID/falling asleep in chair and not wanting to eat), HYPOPHAGIA (not been eating that much since this all this started in Oct-2022) and NEUROLOGICAL DECOMPENSATION (the brain deterioration issue and that was prior to Paxlovid) outcome was unknown.      DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): In October 2022, SARS-CoV-2 test: Positive.         The patient had rebound case after taking Paxlovid. He was positive on 22 Oct 2022. After test he was very faint and a pink line and tested today and still a lighter pink than the first time. He had a little coughing in between being tired all the time. He was not eating that much since this all this started in Oct 2022. He was thin and always had been. He was coughing and thought it was allergies. He had adjutant allergies from moving in the winter. He was falling asleep in chair and not wanting to eat, and cough got worse, so tested him again. He seems quite to not be as bad as first time around and got worse and was tapering off now. He took cough medicine and Tylenol. He started Paxlovid on 22 Oct 2022 and took a dose that day and continued it for full 5-day period. Reporter did notice on the internet that it listed if you were on certain drugs that you should not take them while on it. He was on Carbamazepine, which was one of the things on the list, and did not know if this had something to do with him getting which was one of the things on the list and did not know if this had something to do with him getting rebound or not. She stated he took all his medications as usual. He had blockage in Carotid Arteries. He took a lot of other medications, but nothing related to this. He was disabled prior to taking Paxlovid. He just had the brain deterioration issue and that was prior to Paxlovid. Reporter worried about him being contagious around her. He got the Omicron booster before they came down here in Oct 2022. He was only a little over a week got his booster when he tested positive for COVID. He sits in the house all day. All 3 prior COVID vaccines were Moderna and done in another state.. He received Moderna Omicron booster and still got COVID. Then got Rebound COVID.  Company Comment: This is a spontaneous case that concerns a 73-year-old male subject with relevant concurrent condition of seizures reported, who experienced unexpected, non-serious event of COVID-19 and Neurological decompensation that occurred on unspecified day after the fourth dose of mRNA-1273 BIVALENT .222 vaccine. SARS-CoV-2 test was Positive on unknown day of same month after receiving the current vaccination and patient started NIRMATRELVIR, RITONAVIR (PAXLOVID) 3 days after the vaccination. The patient was also treated with PARACETAMOL (TYLENOL) It was reported that he took a lot of other medications, but nothing related to this. He was disabled prior to taking Paxlovid. He just had the brain deterioration issue and that was prior to Paxlovid. All 3 prior COVID vaccines were Moderna vaccines. No additional information regarding clinical course, concomitant medication, and other treatment. Patient's relevant concurrent condition of seizures remains a risk factor for Neurological decompensation. The event outcome was unknown. The causality of the event COVID-19 was assessed as not applicable, due to lack of biologic plausibility. The event might be explained by current pandemic outbreak.; Sender's Comments: This is a spontaneous case that concerns a 73-year-old male subject with relevant concurrent condition of seizures reported, who experienced unexpected, non-serious event of COVID-19 and Neurological decompensation that occurred on unspecified day after the fourth dose of mRNA-1273 BIVALENT .222 vaccine. SARS-CoV-2 test was Positive on unknown day of same month after receiving the current vaccination and patient started NIRMATRELVIR, RITONAVIR (PAXLOVID) 3 days after the vaccination. The patient was also treated with PARACETAMOL (TYLENOL) It was reported that he took a lot of other medications, but nothing related to this. He was disabled prior to taking Paxlovid. He just had the brain deterioration issue and that was prior to Paxlovid. All 3 prior COVID vaccines were Moderna vaccines. No additional information regarding clinical course, concomitant medication, and other treatment. Patient's relevant concurrent condition of seizures remains a risk factor for Neurological decompensation. The event outcome was unknown. The causality of the event COVID-19 was assessed as not applicable, due to lack of biologic plausibility. The event might be explained by current pandemic outbreak.