cold; sore left arm/soreness in injection site arm; headache; chills; fever/Fever of 102 degrees Fahrenheit/low grade fever; nausea/very nauseous/ feeling nauseous; fatigue/felt like patient had vaccine fatigue at this point/very tired. This spontaneous case was reported by a patient and describes the occurrence of NASOPHARYNGITIS (cold), PAIN IN EXTREMITY (sore left arm/soreness in injection site arm), HEADACHE (headache), CHILLS (chills) and PYREXIA (fever/Fever of 102 degrees Fahrenheit/low grade fever) in a 59-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 060A22A, 058H21A, 007C21A and 026B21A) for COVID-19 prophylaxis. The occurrence of additional non-serious events is detailed below.     The patient did not received any other vaccines in the 4 weeks prior to COVID-19 vaccine.  Concurrent medical conditions included Hypercholesterolaemia (Other than this the patient reports no health care issues.). Concomitant products included ATORVASTATIN CALCIUM (LIPITOR) for Hypercholesterolaemia.   On 30-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 27-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 04-Dec-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 16-Jul-2022, received fourth dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. In 2021, the patient experienced NASOPHARYNGITIS (cold), PAIN IN EXTREMITY (sore left arm/soreness in injection site arm), HEADACHE (headache), CHILLS (chills), PYREXIA (fever/Fever of 102 degrees Fahrenheit/low grade fever), NAUSEA (nausea/very nauseous/ feeling nauseous) and FATIGUE (fatigue/felt like patient had vaccine fatigue at this point/very tired.). In 2021, NASOPHARYNGITIS (cold), PAIN IN EXTREMITY (sore left arm/soreness in injection site arm), HEADACHE (headache), CHILLS (chills), PYREXIA (fever/Fever of 102 degrees Fahrenheit/low grade fever), NAUSEA (nausea/very nauseous/ feeling nauseous) and FATIGUE (fatigue/felt like patient had vaccine fatigue at this point/very tired.) had resolved.      DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Body temperature: 102  degrees Fahrenheit.     For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments.   It was reported that after second dose of vaccine patient also had low grade fever, soreness in injection site arm, chills, nausea and headache. Side effects resolved in 2 to 3 days.After the first Moderna Covid 19 vaccine booster patient also had sore left arm, headache, chills, feeling nauseous, and very tired. Side effects resolved in 2 to 3 days. The patient received second Moderna Covid 19 vaccine booster dose and experienced  adverse reactions that were more serious in nature than in her 3 previous vaccinations. Patient had a sore left arm, severe headache, nausea, fever of 102 degrees Fahrenheit, and severe chills. Patient felt like vaccine fatigue at that point so waited a while to get bivalent booster dose. No treatment information was provided.   This case was linked to US-MODERNATX, INC.-MOD-2023-712855 (E2B Linked Report).; Sender's Comments:  US-MODERNATX, INC.-MOD-2023-712855:Bivalent dose