can't asleep because it's so painful; can't reach above shoulder/can't reach behind her back / struggle to buckle and unbuckle bra / can't reach for things; muscle atrophy on that left arm; needle may have hit a nerve; pain in the left arm/has pain in the injection area on the left arm/ongoing symptoms/sharpened the pain to a stabbing pain; between upper left arm and elbow there is a deep muscle type of pain/pain originally was a deep muscle pain; 3 inches below the actual injection site she can feel a knot.; This spontaneous case was reported by a patient and describes the occurrence of POOR QUALITY SLEEP (can't asleep because it's so painful), VACCINATION SITE MOVEMENT IMPAIRMENT (can't reach above shoulder/can't reach behind her back / struggle to buckle and unbuckle bra / can't reach for things), MUSCLE ATROPHY (muscle atrophy on that left arm), NERVE INJURY (needle may have hit a nerve) and VACCINATION SITE PAIN (pain in the left arm/has pain in the injection area on the left arm/ongoing symptoms/sharpened the pain to a stabbing pain) in an elderly female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 027A21A and 027B21A) for COVID-19 prophylaxis. The occurrence of additional non-serious events is detailed below.     No medical history was provided by the reporter. Patient was over 65 years old.  Concurrent medical conditions included Asthmatic (Patient was born asthmatic and took very minimal things like an inhaler.).   On 04-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 01-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 25-Oct-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient experienced POOR QUALITY SLEEP (can't asleep because it's so painful), VACCINATION SITE MOVEMENT IMPAIRMENT (can't reach above shoulder/can't reach behind her back / struggle to buckle and unbuckle bra / can't reach for things), MUSCLE ATROPHY (muscle atrophy on that left arm), NERVE INJURY (needle may have hit a nerve), VACCINATION SITE PAIN (pain in the left arm/has pain in the injection area on the left arm/ongoing symptoms/sharpened the pain to a stabbing pain), MYALGIA (between upper left arm and elbow there is a deep muscle type of pain/pain originally was a deep muscle pain) and VACCINATION SITE MASS (3 inches below the actual injection site she can feel a knot.). The patient was treated with ACETYLSALICYLIC ACID (BABY ASPIRIN) at a dose of 1 dosage form and PARACETAMOL (TYLENOL) at a dose of 1 dosage form. At the time of the report, POOR QUALITY SLEEP (can't asleep because it's so painful), VACCINATION SITE MOVEMENT IMPAIRMENT (can't reach above shoulder/can't reach behind her back / struggle to buckle and unbuckle bra / can't reach for things), MUSCLE ATROPHY (muscle atrophy on that left arm), NERVE INJURY (needle may have hit a nerve), VACCINATION SITE PAIN (pain in the left arm/has pain in the injection area on the left arm/ongoing symptoms/sharpened the pain to a stabbing pain), MYALGIA (between upper left arm and elbow there is a deep muscle type of pain/pain originally was a deep muscle pain) and VACCINATION SITE MASS (3 inches below the actual injection site she can feel a knot.) had not resolved.        mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) dosing remained unchanged.       Concomitant product included inhaler for asthma.  Patient was a senior over 65 years old. Patient considered herself as high risk based on her respiratory system.  Patient tried physical therapy for about 4 months which did not alleviate but sharpened the pain to a stabbing pain. Patient reported the physical therapist tried needling around the shoulder and down from the neck and relieved the tension in the neck but had no effect on the arm. Patient was not doing therapy for the 4 months. Patient had no issues with the second and her booster dose. Patient also reported that doctor's next step was to do x-ray ultrasound.