Sex: M
Vaccine: COVID19-2
Symptoms: COVID-19
Clinical narrative: had covid after having the Moderna covid vaccines; This spontaneous case was reported by a physician and describes the occurrence of COVID-19 (had covid after having the Moderna covid vaccines) in an elderly male patient who received mRNA-1273 BIVALENT .222 (MODERNA COVID-19 VACCINE, BIVALENT (ORIGINAL AND OMICRON BA.4/BA.5)) for COVID-19 prophylaxis.     Concurrent medical conditions included Psoriatic arthritis (for 2 years) and Blood cholesterol abnormal. Concomitant products included APREMILAST (OTEZLA), PITAVASTATIN CALCIUM (LIVALO) and EZETIMIBE for Blood cholesterol abnormal, TOFACITINIB CITRATE (XELJANZ XR) for Psoriatic arthritis, IBUPROFEN, NAPROXEN SODIUM, MELOXICAM, DICLOFENAC, OMEPRAZOLE and METHOTREXATE for an unknown indication.    On an unknown date, the patient received 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 COVID-19 (had covid after having the Moderna covid vaccines). At the time of the report, COVID-19 (had covid after having the Moderna covid vaccines) outcome was unknown.        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.   Patient had pain in different joints, experienced psoriatic plaques and the doctor had blood work done on him and prescribed different NSAIDS that did not do too well. It was not just pain and there was swelling stiffness, loss of mobility and this was before taking Xeljanz XR.  Patient did not experience any GI effects form Omeprazole but took it when he took the NSAIDS to try to diminish the GI side effects from the NSAIDS. The methotrexate he took seemed to help but his liver enzymes went high, and he got taken off of that. Patient was then put on cholesterol medications and tried Otezla for a year with no relief as far as pain; Patient was on cholesterol medications before he started taking the Methotrexate and the Otezla was after his liver enzymes were going up significantly because he was on the cholesterol medications which he needed and needed the Methotrexate; he was taken off all medications at which point they redid the blood work and the liver enzymes went down to normal and he started the cholesterol medications again and his liver enzymes were stable so his deduction was that it was the Methotrexate in combination with the cholesterol medications which caused his liver enzymes to elevate. For the cholesterol medications he was on, which are Livalo and also Ezetimibe and was not sure when he began taking those, but it was before he was diagnosed with psoriatic arthritis. The Otezla he was put on after his liver enzymes returned to normal was to try another medication that would diminish the symptomatology of the Psoriatic arthritis; the Otezla was the second one he tried for psoriatic arthritis after bang on the methotrexate and after the liver enzyme returned to normal. Doctor wanted patient to try biologic treatments, so prescribed him on Enbrel and Remicade and other oral medications; patient said that was the next step was biologics and so the choices were injectables or oral medications such as Xeljanz and he chose to do the Xeljanz; patient clarified he had not taken the Enbrel or Remicade or the other oral medications.  Patient said even though his system was immune compromised because of the covid, he was not anxious about taking those medications during covid; patient was anxious about taking Xeljanz and weighed the pros and cons and was up to date on all his vaccines and immunizations, so he decided to continue the Xeljanz.  Patient had covid and was nervous about being on Xeljanz and then caught covid and even though patient was fully vaccinated with Moderna and boosted every 6 months and took precaution and was not hospitalized and isolated at home and at that point he stopped the Xeljanz himself because felt it might be prudent to do that. Patient did read on it and also contacted his doctor and said it might be better being on it and so he went back on the Xeljanz XR 11mg; he does not attribute getting covid to the Xeljanz XR and lots of people who aren't on Xeljanz and got vaccines got covid too.  He had no swelling and no pain on the Xeljanz XR but then did say he still gets pain and stiffness depending on the weather; but it was not to the extent he had it before taking the Xeljanz XR and sees a distinct improvement and it was not a cure, but it was a distinct improvement with use of the Xeljanz XR.  Patient's doctor has him on analgesics Tramadol and Tylenol; his internist had given him Tramadol if he needs it and sometimes the Tylenol also and it depends on a particular day. Patient does not want to take any medications and if there was weather it affects him if it was cold or damp out or he has symptoms. Patient had periodic bloodwork done and had no dates of that to provide but the bloodwork had been good and the ESR and c-reactive protein are good, and patient's WBC count was good and there was no significant elevation of liver enzymes.  Treatment drug was not reported.   Most recent FOLLOW-UP information incorporated above includes: On 08-Mar-2023: Live follow-up content no new information.