I have had no post-injection systemic symptoms, and no spontaneous discomfort and only minimal pain to palpation at the injection site.; This spontaneous case was reported by a physician and describes the occurrence of VACCINATION SITE PAIN (I have had no post-injection systemic symptoms, and no spontaneous discomfort and only minimal pain to palpation at the injection site.) in a 70-year-old patient of an unknown gender who received mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) for COVID-19 prophylaxis.     The patient's past medical history included COVID-19 (Developed COVID in the following April and was treated as an outpatient with a single bebtelovimab infusion and oral antibiotics.) in April 2022 and Pneumonia (Developed pneumonia in the following April and was treated as an outpatient with a single bebtelovimab infusion and oral antibiotics.) in April 2022. Previously administered products included for Drug use for unknown indication: bebtelovimab (single bebtelovimab infusion and oral antibiotics.). Past adverse reactions to the above products included No adverse event with bebtelovimab. Concurrent medical conditions included Diabetes mellitus, Hypertension, Paroxysmal atrial fibrillation and Overweight.    On 23-Apr-2023, the patient received dose of mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (unknown route) 1 dosage form. On an unknown date, the patient experienced VACCINATION SITE PAIN (I have had no post-injection systemic symptoms, and no spontaneous discomfort and only minimal pain to palpation at the injection site.). At the time of the report, VACCINATION SITE PAIN (I have had no post-injection systemic symptoms, and no spontaneous discomfort and only minimal pain to palpation at the injection site.) outcome was unknown.        For mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (Unknown), the reporter did not provide any causality assessments.   Concomitant medication use information was not provided by reporter.  Patient took first booster injection in September 2022.  Patient was undergoing evaluation in pulmonary for chronic exertional dyspnea with cough and loss of core muscle strength with no pulmonary abnormalities identified thus far.  But patient was concerned about being at high risk for potentially serious pulmonary complications from another episode of COVID and hoping to gain the maximal protection afforded by the COVID bivalent booster.  The pharmacist administered injection uneventfully, but it occurred to patient only afterwards that pharmacist may not considered weight (274lbs) in selection of the needle that used.  Pharmacist reflexively used the 25-gauge x 1 inch needle most often used in vaccine clinics. After confirming it was 1.5-inch needle in fact recommended for use in patients with weight and understanding the importance of a successful IM injection to elicit the most robust antibody response.  Patient had no post injection systemic symptoms and no spontaneous discomfort and only minimal pain to palpation at the injection site.   Treatment medication use information was not provided by reporter.