Age: 63.0
Sex: M
Vaccine: VARZOS
Symptoms: Biopsy, Diffuse large B-cell lymphoma, Herpes zoster, Post herpetic neuralgia, Vaccination failure
Clinical narrative: complicated by post herpetic neuralgia; diffuse large b cell lymphoma; shingles; suspected vaccination failure/ shingrix vaccine on 13Jun2020, shingles on 29Mar2021; This case was reported by a physician via other manufacturer and described the occurrence of suspected vaccination failure in a 64-year-old male patient who received Herpes zoster (Shingrix) for prophylaxis.   Co-suspect products included tofacitinib citrate (Xeljanz) tablet for ulcerative colitis.   Concurrent medical conditions included ulcerative colitis.   On 13th June 2020, the patient received Shingrix. On 9th June 2020, the patient started Xeljanz 5 mg twice daily (10 mg daily). On 29th March 2021, 289 days after receiving Shingrix, the patient experienced vaccination failure (serious criteria hospitalization, GSK medically significant and other: Medically significant) and shingles (serious criteria hospitalization and other: Medically significant). On 15th June 2021, the patient experienced diffuse large b-cell lymphoma (serious criteria hospitalization, GSK medically significant and life threatening). On an unknown date, the patient experienced post herpetic neuralgia (serious criteria hospitalization). The patient was treated with prednisone and steroids nos (Steroids). The action taken with Xeljanz was unknown. On an unknown date, the outcome of the vaccination failure and post herpetic neuralgia were unknown and the outcome of the diffuse large b-cell lymphoma was resolved with sequelae and the outcome of the shingles was recovered/resolved.   The reporter considered the vaccination failure, diffuse large b-cell lymphoma and shingles to be related to Shingrix. It was unknown if the reporter considered the post herpetic neuralgia to be related to Shingrix.  Additional details were provided as follows: The reporter was a gastroenterologist. The patient had no history of lymphoma. 445 days after receiving the first dose of Xeljanz, the patient was diagnosed with shingles and 367 days after receiving vaccination and 372 days after receiving the first dose of Xeljanz, the patient had diffuse large b-cell lymphoma. On an unknown date, less than 2 years after Shingrix and Xeljanz, diffuse large b-cell lymphoma was complicated by post herpetic neuralgia. The patient had multiple hospitalization with biopsies, etc. The patient did end up recovering with treatment. The patient was also taking steroids and prednisone but did not felt they were relevant. Medical test results were stated as just pertaining to his diagnosis. The reporter did not wish to provide his complete mailing address. The reporter considered the diffuse large b-cell lymphoma and shingles to be related to Xeljanz. It was unknown if the reporter considered the post herpetic neuralgia to be related to Xeljanz. The reporter consented to follow up. No further details were provided. This case was considered as suspected vaccination failure as details regarding the completion of primary vaccination schedule and laboratory confirmation regarding shingles were unknown at the time of reporting.