throat discomfort; body aches; Thyroiditis after Bivalent booster / Ultrasound of Neck showed Thyroiditis after Bivalent booster; Fever 101F after Bivalent booster / Still runs low fever despite drinking enough water, after Bivalent booster; This spontaneous case was reported by a nurse and describes the occurrence of THYROIDITIS (Thyroiditis after Bivalent booster / Ultrasound of Neck showed Thyroiditis after Bivalent booster), OROPHARYNGEAL DISCOMFORT (throat discomfort), PYREXIA (Fever 101F after Bivalent booster / Still runs low fever despite drinking enough water, after Bivalent booster) and MYALGIA (body aches) in a 67-year-old male patient who received mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (batch no. AS7144B) for COVID-19 vaccination.     No known allergy.  The patient's past medical history included Neck pain and Wide excision of melanoma (Patient had melanoma removed from arms several years ago). Concurrent medical conditions included Enlarged prostate, Hyperlipidemia, Anxiety disorder and Malignant melanoma (malignant melanoma 2017, basal and squamous cell) since 2017. Concomitant products included ESCITALOPRAM OXALATE for Anxiety disorder, SIMVASTATIN for Hyperlipidemia, VITAMIN D3, CURCUMA LONGA (TURMERIC [CURCUMA LONGA]) and PROBIOTIC [BIFIDOBACTERIUM BIFIDUM;BIFIDOBACTERIUM LACTIS;BIFIDOBACTERIUM LONGUM;LACTOBACILLUS ACIDOPHILUS;LACTOBACILLUS RHAMNOSUS] for an unknown indication.    On 03-Sep-2022, the patient received fourth dose of mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (Intramuscular) 1 dosage form. On 19-Sep-2022, the patient experienced THYROIDITIS (Thyroiditis after Bivalent booster / Ultrasound of Neck showed Thyroiditis after Bivalent booster) and PYREXIA (Fever 101F after Bivalent booster / Still runs low fever despite drinking enough water, after Bivalent booster). On 20-Sep-2022, the patient experienced OROPHARYNGEAL DISCOMFORT (throat discomfort) and MYALGIA (body aches). The patient was treated with AMOXICILLIN at an unspecified dose and frequency; PARACETAMOL (TYLENOL) at an unspecified dose and frequency; ACETAMINOPHEN at a dose of every evening; ZINC at a dose of 3 days; FLUTICASONE PROPIONATE (FLONASE ALLERGY RELIEF) at a dose of nasal spray; FLUTICASONE PROPIONATE, SALMETEROL XINAFOATE (ADVAIR) at a dose of inhaler; ATENOLOL on 05-Oct-2022 at an unspecified dose and frequency; METHIMAZOLE on 05-Oct-2022 at an unspecified dose and frequency and PREDNISONE on 05-Oct-2022 at an unspecified dose and frequency. On 05-Oct-2022, PYREXIA (Fever 101F after Bivalent booster / Still runs low fever despite drinking enough water, after Bivalent booster) had resolved. At the time of the report, THYROIDITIS (Thyroiditis after Bivalent booster / Ultrasound of Neck showed Thyroiditis after Bivalent booster), OROPHARYNGEAL DISCOMFORT (throat discomfort) and MYALGIA (body aches) outcome was unknown.      DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 19-Sep-2022, Body temperature: Fever of 101 F. On 19-Sep-2022, SARS-CoV-2 test: (Negative) Covid Negative. On 21-Sep-2022, SARS-CoV-2 test: (Negative) Negative. On 29-Sep-2022, Influenza virus test: (Negative) Negative. On 29-Sep-2022, SARS-CoV-2 test: (Negative) Negative. On 29-Sep-2022, Streptococcus test: (Negative) Negative. On 04-Oct-2022, Anti-thyroid antibody: 12.50. On 04-Oct-2022, Blood thyroid stimulating hormone: 0.006. On 04-Oct-2022, Chest X-ray: (Negative) Negative. On 04-Oct-2022, Lipase: 53. On 04-Oct-2022, Red blood cell sedimentation rate: 31. On 04-Oct-2022, Thyroxine free: 4.29. On 04-Oct-2022, Ultrasound scan: Ultrasound of Neck showed Thyroiditis. On 05-Oct-2022, Anti-thyroid antibody: 18 and 14.10. On 05-Oct-2022, Blood thyroid stimulating hormone: 0.006 and Less than 1. On 05-Oct-2022, Thyroxine free: 4.65. On an unknown date, Urine analysis: (Negative) Negative.     For mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (Intramuscular), the reporter did not provide any causality assessments.   It was reported that all previous shots were Moderna COVID-19 vaccines. First dose: On  12JAN2021 (Lot  037K20A & MFG Exp. Date: unknown). 2nd shot: On 08FEB2021 (Lot 043L20A  & MFG Exp. Date: unknown). First booster  on 22NOV2021 (Lot 069F21A & MFG Exp. Date: unknown). All Moderna COVID-19 vaccines given intramuscular on arm. It was reported that patient had Negative COVID Test after Bivalent booster. Patient had symptoms as saturated bedding with sweat on 5Oct2022.   Most recent FOLLOW-UP information incorporated above includes: On 10-Oct-2022: Follow-up received contains no new information On 11-Oct-2022: Significant live follow up received contains Dose details, Patient information, Medical history, Concomitant medications, Additional events, lab test,  event details and Case narrative updated. Treatment drug added.