Patient have received Booster dose of MODERNA COVID-19 VACCINE, BIVALENT omicron 4th and 5th dose; COVID-19/Cough/Cough got worse and worse real sick/got very sick/ runny nose/ no appetite/spitting out a lot of junk/headache/ slight fever; This spontaneous case was reported by a patient and describes the occurrence of COVID-19 (COVID-19/Cough/Cough got worse and worse real sick/got very sick/ runny nose/ no appetite/spitting out a lot of junk/headache/ slight fever) and EXTRA DOSE ADMINISTERED (Patient have received Booster dose of MODERNA COVID-19 VACCINE, BIVALENT omicron 4th and 5th dose) in an 87-year-old male patient who received mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (batch no. 043H22A) for COVID-19 prophylaxis.    Co-suspect products included non-company products PNEUMOCOCCAL VACCINE for an unknown indication and TETANUS VACCINE TOXOID (TETANUS VACCINE [TETANUS VACCINE TOXOID]) for an unknown indication.    The patient's past medical history included Glaucoma. Previously administered products included for COVID-19 prophylaxis: Moderna Covid-19 Vaccine (First dose lot number 030M20A) on 12-Feb-2021, Moderna Covid-19 Vaccine (Second dose lot number 027A21A) on 12-Mar-2021 and Moderna Covid-19 Vaccine (Third dose lot number 014B22A) on 10-Jun-2022. Past adverse reactions to the above products included No adverse event with Moderna Covid-19 Vaccine, Moderna Covid-19 Vaccine and Moderna Covid-19 Vaccine. Concurrent medical conditions included Hypertension.   On 20-Dec-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) dosage was changed to 1 dosage form. On an unknown date, the patient received fifth dose of mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (unknown route) 1 dosage form, dose of PNEUMOCOCCAL VACCINE (unknown route) 1 dosage form and dose of TETANUS VACCINE TOXOID (TETANUS VACCINE [TETANUS VACCINE TOXOID]) (unknown route) 1 dosage form. In June 2023, the patient experienced COVID-19 (COVID-19/Cough/Cough got worse and worse real sick/got very sick/ runny nose/ no appetite/spitting out a lot of junk/headache/ slight fever). On an unknown date, the patient experienced EXTRA DOSE ADMINISTERED (Patient have received Booster dose of MODERNA COVID-19 VACCINE, BIVALENT omicron 4th and 5th dose). At the time of the report, COVID-19 (COVID-19/Cough/Cough got worse and worse real sick/got very sick/ runny nose/ no appetite/spitting out a lot of junk/headache/ slight fever) and EXTRA DOSE ADMINISTERED (Patient have received Booster dose of MODERNA COVID-19 VACCINE, BIVALENT omicron 4th and 5th dose) outcome was unknown.      DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, SARS-CoV-2 test: Positive.     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.   No concomitant medication was reported.  Patient had pneumococcal and tetanus vaccine together with a Covid-19 vaccine but he did not have the information which dose of the Covid-29 vaccine they were given at the same time with. No treatment information was reported.