coughing; heart racing; short of breath; her arm was swollen up; Also got so week; arm was hot where covid-19 shot went in; Could not lift up left arm at all; fever; chills; left arm (injection arm) was hurting her horrible; This spontaneous case was reported by a patient and describes the occurrence of COUGH (coughing), PALPITATIONS (heart racing), DYSPNOEA (short of breath), PERIPHERAL SWELLING (her arm was swollen up) and ASTHENIA (Also got so week) in a 55-year-old female patient who received mRNA-1273.815 (SPIKEVAX 2023-2024) (batch no. ASKU) for COVID-19 prophylaxis. The occurrence of additional non-serious events is detailed below.    Co-suspect product included non-company product PARACETAMOL (TYLENOL) for an unknown indication.    The patient's past medical history included Heart attack. Previously administered products included for Product used for unknown indication: Influenza vaccine on 28-Sep-2023; for COVID-19 prophylaxis: Moderna COVID-19 vaccine (Dose 2) and Moderna COVID-19 vaccine (Dose 1). Past adverse reactions to the above products included No adverse event with Influenza vaccine, Moderna COVID-19 vaccine and Moderna COVID-19 vaccine. Concurrent medical conditions included Asthma and Heart disorder.   On 28-Sep-2023, the patient received third dose of mRNA-1273.815 (SPIKEVAX 2023-2024) (unknown route) 1 dosage form. On an unknown date, the patient started PARACETAMOL (TYLENOL) (unknown route) at an unspecified dose. On 28-Sep-2023,  after starting mRNA-1273.815 (SPIKEVAX 2023-2024), the patient experienced INJECTION SITE PAIN (left arm (injection arm) was hurting her horrible). On 29-Sep-2023, the patient experienced PERIPHERAL SWELLING (her arm was swollen up), ASTHENIA (Also got so week), INJECTION SITE WARMTH (arm was hot where covid-19 shot went in), MOBILITY DECREASED (Could not lift up left arm at all), PYREXIA (fever) and CHILLS (chills). On 30-Sep-2023, the patient experienced COUGH (coughing), PALPITATIONS (heart racing) and DYSPNOEA (short of breath). At the time of the report, COUGH (coughing), PALPITATIONS (heart racing), DYSPNOEA (short of breath), PYREXIA (fever) and CHILLS (chills) had not resolved and PERIPHERAL SWELLING (her arm was swollen up), ASTHENIA (Also got so week), INJECTION SITE WARMTH (arm was hot where covid-19 shot went in), MOBILITY DECREASED (Could not lift up left arm at all) and INJECTION SITE PAIN (left arm (injection arm) was hurting her horrible) outcome was unknown.        For mRNA-1273.815 (SPIKEVAX 2023-2024) (Unknown), the reporter did not provide any causality assessments.   No concomitant medications were reported. On 28-SEP-2023, patient had new covid shot and flu shot at a pharmacy. She has also had previous Moderna COVID-19 vaccines. When she tried to go to bed her left arm (injection arm) was hurting her horrible. On 29-Sep-2023, morning she woke up, her arm was swollen up, she had fever, and chills. Also got so week, arm was hot where covid-19 shot went in. Could not lift up left arm at all. Used ice packs on arm and took Tylenol. 30-Sep-2023, coughing, arm hurting, heart was racing. Pharmacist recommended using heat on her left arm. Heart racing and short of breath. No treatment medications were provided.