Age: 70.0
Sex: F
Vaccine: PPV
Symptoms: Musculoskeletal stiffness, Nausea, Pain, Pain in extremity, Peripheral swelling
Clinical narrative: her right arm was a little stiff; her right arm was pink; her arm was swollen; she started feeling weak; low grade fever around 99.8 but it never went above 100.; her blood sugar was low; The consumer reported she had some nausea that subsided after eating.; arm soreness right; Stiff neck; it hurt to move her right arm; she did not have a lot of sensation in the shoulder; she felt lightheaded; cold swaets; sweating profusely; she fall; walker user; difficulty in walking; movement reduced; This spontaneous report was received from an 70 year old female patient reporting on herself.  The patient's pertinent medical history included: left wrist fracture with metal plates, right wrist fracture and hip and leg fracture and her concurrent conditions included: diabetes mellitus, polyarthritis, osteoporosis in hip and spine. The patient's previously allergies included: codeine, meclizine hydrochloride (ANTIVERT), methotrexate and "all mycins" (the patient reported additional unspecifed allergies that she could not remember and reported we could get the full list from her physician), and her concomitant therapies included: etanercept (ENBREL), metformin hydrochloride, sitagliptin phosphate(JANUMET), glipizide, simvastatin (ZOCOR), hydrocodone, lisinopril, promethazine,ranitidine (reported as "ramatidine"), prednisone, duloxetine hydrochloride (CYMBALTA), fluoxetine, risedronate sodium, leflunomide and cyclobenzaprine hydrochloride (FLEXERIL).  On 02-MAY-2019, the patient was vaccinated with pneumococcal vaccine, polyvalent (23-valent) (PNEUMOVAX23) 1 dosage form, intramuscularly, in right arm for prophylaxis (lot # R034248 and expiration date: 07-AUG-2020).      At the same day (reporter as:  "later that day"), the patient's  right arm was a little stiff (injected limb mobility decreased), pink (erythema), and swollen (peripheral swelling), and at the night she started feeling weak (asthenia) and running a low grade fever(pyrexia) around 99.8 (units not provided) but it never went above 100 (units not provided). At midnight that night, she got up to go to the bathroom and her knees buckled under her and she fall and did not have enough strength to get back in bed, she struggled for four hours and then called her sister to get her off the floor because she was also diabetic and felt her blood sugar was low (blood glucose decreased). Her sister got her off the floor and gave her something to eat and drink and stayed with her because she felt extremely weak and her sister had to help her on and off the commode. The patient had some nausea that subsided after eating. She could not raise her right arm (hypokinesia), it was sore (pain in extremity) to the touch and stiff from the elbow to the shoulder and up the neck (neck stiffness). The consumer reported it hurt to move her right arm (pain in extremity) and she did not have a lot of sensation in the shoulder (sensory disturbance). The patient rubbed the arm with diphenhydramine (BENADRYL)gel without relief.   The patient felt lightheaded (dizziness), had cold sweats (cold sweat), was sweating profusely and could not stand without assistance (gait disturbance), she normally walked with a cane, but due to this she had to use her walker (walker user).  The patient did call her physician and the office asked if she thought she needed to come in to be seen and she reported she did not and thought she just needed to stay off her feet and rest.   The patient reported that these symptoms have lasted for the last two weeks but today was the first day she was able to raise her right arm chest high without assistance from the left arm and was feeling stronger today.  The patient reported that she still can't scratch her nose, rub her eye, or comb her hair with the right arm, and that this reaction to the pneumococcal vaccine, polyvalent (23-valent) (PNEUMOVAX23) was more debilitating than when she broke her hip and leg two years ago and reported she had less trouble recovering from that.    The outcome of the events injected limb mobility decreased, hypokinesia, gait disturbance, walking aid user, fall, hyperhidrosis, cold sweat, dizziness, sensory disturbance, musculoskeletal stiffness, pain in extremity, nausea, blood glucose decreased, pyrexia, asthenia, peripheral swelling and erythema was reported as resolving.        The causality relationship with the reported events and the therapy with pneumococcal vaccine, polyvalent (23-valent) (PNEUMOVAX) was not provided.