It was bright red; severe rash that started in the warm areas and then it spread all over, It was only from the groin to the top of breast in the front of body on the left and right side, fiery rash, it was sore; some rash on arm where had the injection; This spontaneous case was reported by a patient and describes the occurrence of RASH ERYTHEMATOUS (It was bright red), RASH (severe rash that started in the warm areas and then it spread all over, It was only from the groin to the top of breast in the front of body on the left and right side, fiery rash, it was sore) and VACCINATION SITE RASH (some rash on arm where had the injection) in an 80-year-old female patient who received mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) (batch no. 051D22A) for COVID-19 vaccination.     It was reported that patient had no medical history. Patient never had COVID positive test or diagnosis.  Previously administered products included for Product used for unknown indication: FLU [INFLUENZA VACCINE] (flu shot one week before 22Oct2022 (patient thoughts it was around 15Oct2022)) on 15-Oct-2022. Past adverse reactions to the above products included No adverse event with FLU [INFLUENZA VACCINE]. Concurrent medical conditions included Allergy to arthropod bite (Allergy to fire ants, had an anaphylactic shock with fire ants).    On 22-Oct-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) 1 dosage form. On an unknown date, the patient experienced RASH ERYTHEMATOUS (It was bright red), RASH (severe rash that started in the warm areas and then it spread all over, It was only from the groin to the top of breast in the front of body on the left and right side, fiery rash, it was sore) and VACCINATION SITE RASH (some rash on arm where had the injection). The patient was treated with HAMAMELIS VIRGINIANA EXTRACT (WITCH HAZEL [HAMAMELIS VIRGINIANA EXTRACT]) at an unspecified dose and frequency and CORTISONE at an unspecified dose and frequency. At the time of the report, RASH ERYTHEMATOUS (It was bright red), RASH (severe rash that started in the warm areas and then it spread all over, It was only from the groin to the top of breast in the front of body on the left and right side, fiery rash, it was sore) and VACCINATION SITE RASH (some rash on arm where had the injection) had resolved.            Concomitant drugs were not reported.  On 09-Jan-2021, Patient received first dose of moderna shot with lot number 012120A.  On 10-Feb-2021, Patient received dose second dose of moderna shot with lot number 010M20A.  On 22-Oct-2021, Patient received 1st booster of moderna shot with lot number 011F21A.  It was reported that patient thought it was shingles. Patient was uncomfortable but not life-threatening.   Patient had no problem with other three doses.   Patient seek office visit on 26-Oct-2022.  The patient reported trying everything with witch hazel, cortisone and medicated powder. Nothing worked. She went to the doctor, who gave her a big shot. It was a steroid. Two days later, she took steroid, antihistamine pills and her rash recovered.   Most recent FOLLOW-UP information incorporated above includes: On 21-Nov-2022: No new information received.