it's a sharp, dull pain; pain in shoulder, on the right side/moved down to elbow last night/then into wrist/back to  elbow again this morning/goes away only for 2 minutes and comes back/gets very intense/the pain is relentless/is so bad/the pain has been stable; pain in shoulder, on the right side/it's deep down in  arm/feels like it's down in the bones; couldn't sleep for 3 days due to the pain; This spontaneous case was reported by a patient and describes the occurrence of PAIN (it's a sharp, dull pain), INSOMNIA (couldn't sleep for 3 days due to the pain), ARTHRALGIA (pain in shoulder, on the right side/moved down to elbow last night/then into wrist/back to  elbow again this morning/goes away only for 2 minutes and comes back/gets very intense/the pain is relentless/is so bad/the pain has been stable) and VACCINATION SITE PAIN (pain in shoulder, on the right side/it's deep down in  arm/feels like it's down in the bones) in a 72-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 049L21A, 011M20A, 032M20A and 011F21A) for COVID-19 vaccination.     The patient had never COVID positive test or diagnosed with it. It was reported that patient did not take any other vaccines within 1 month prior to Moderna COVID-19 vaccine.  Concurrent medical conditions included Drug allergy (Aspirin allergy) and COPD (Started 5 years ago, recent changes in status was stable.).   On 04-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) .5 milliliter. On 05-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to .5 milliliter. On 03-Nov-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to .25 milliliter. On 22-May-2022, received fourth dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to .25 milliliter. On 14-Aug-2022, the patient experienced PAIN (it's a sharp, dull pain), ARTHRALGIA (pain in shoulder, on the right side/moved down to elbow last night/then into wrist/back to  elbow again this morning/goes away only for 2 minutes and comes back/gets very intense/the pain is relentless/is so bad/the pain has been stable) and VACCINATION SITE PAIN (pain in shoulder, on the right side/it's deep down in  arm/feels like it's down in the bones). In August 2022, the patient experienced INSOMNIA (couldn't sleep for 3 days due to the pain). The patient was treated with PREDNISONE at an unspecified dose and frequency. At the time of the report, PAIN (it's a sharp, dull pain), ARTHRALGIA (pain in shoulder, on the right side/moved down to elbow last night/then into wrist/back to  elbow again this morning/goes away only for 2 minutes and comes back/gets very intense/the pain is relentless/is so bad/the pain has been stable) and VACCINATION SITE PAIN (pain in shoulder, on the right side/it's deep down in  arm/feels like it's down in the bones) had not resolved and INSOMNIA (couldn't sleep for 3 days due to the pain) outcome was unknown.            Patient weight was reported as 185. Concomitant products were not reported.  Patient had been experiencing an intense pain in his right shoulder. The pain seemed to be moving as last night it moved into his right elbow and then into his right wrist. The next morning, the pain was back in right elbow again. Patient said that it was a relentless pain that did not seem to go away. If patient got some relief for 2 minutes and then it came right back, very intense. Patient stated that he was unable to sleep for the last 3 nights due to the pain. Primary care doctor prescribed prednisone, however, that did not help. Patient tried to rotate heat and ice packs to painful areas, but did not subside. Patient described the pain as sharp and dull pain which felt like its down in the bones, like it was deep down in arm. The pain remained stable since it first started without any improvement or worsening.