Sex: U
Vaccine: PPV, TDAP
Symptoms: Extensive swelling of vaccinated limb, Impaired work ability, Injected limb mobility decreased, Injection site pain, Magnetic resonance imaging abnormal
Clinical narrative: Score joint from shoulder to arm; patient had partial tear of her right rotator cuff which was referred as 'Frozen shoulder'; patient had partial tear of her right rotator cuff; pain in right shoulder which was 8 on scale of 1 to 10 and that her right arm was burring and throbbing; right shoulder pain/ Patient had pain at injection site where the vaccine administered; patient shoulder pain was so substantial that she was unable to move her hand and arm; Initial information was received on 16-Jun-2020 regarding an unsolicited valid non-serious case from a physician via lawyer via consumer.  This case involves patient who experienced serious right shoulder pain/ patient had pain at injection site where the vaccine administered (vaccination site pain), score joint from shoulder to arm (extensive swelling of vaccinated limb), shoulder pain became so substantial that she was unable to move her hand and arm (mobility decreased), pain was an 8 on scale of 1 to 10 and that her right arm was burning and throbbing (pain), partial tear of her right rotator cuff (rotator cuff syndrome) which was referred as 'frozen shoulder' (periarthritis), while patient received vaccines PNEUMOVAX 23 and DIPHTHERIA-2/TETANUS/5 AC PERTUSSIS VACCINE [ADACEL].  Medical history, medical treatment, vaccination and family history were not provided. Concomitant medication if any, not reported.  On 03-Apr-2018, the patient received a dose of suspect DIPHTHERIA-2/TETANUS/5 AC PERTUSSIS VACCINE [lot C5446AA, expiry date not reported] and a dose of suspect PNEUMOVAX 23 (not produced by Sanofi Pasteur) [lot N005597, expiry date not reported] via an unknown route in the right shoulder for prophylactic vaccination.  On an unknown date, the patient developed non-serious score joint from shoulder to arm (extensive swelling of vaccinated limb) (unknown latency), following the administration of DIPHTHERIA-2/TETANUS/5 AC PERTUSSIS VACCINE and PNEUMOVAX 23. On 04-Apr-2018, the patient developed a non-serious right shoulder pain/ patient had pain at injection site where the vaccine administered (vaccination site pain) 1 day (reported as: less than 48 hours) following the administration of DIPHTHERIA-2/TETANUS/5 AC PERTUSSIS VACCINE and PNEUMOVAX 23. On the same day, the patient shoulder pain became so substantial that she was unable to move her hand and arm (mobility decreased).  Patient was treated with Ibuprofen and Icing her arm for the next 48 hours and advised to stay at home for 24 to 48 hours and not go to work. It was reported that, on or about 09-Apr-2018, the pain in her right shoulder was constant and patient was able to obtain some relief from IBUPROFEN, but the pain was still an 8 on scale of 1 to 10 and that her right arm was burning and throbbing (pain).  Patient was advised to avoid lifting with the affected arm and to put ice or cold pack on the score joint for 10 to 20 minutes at a time every 1 to 2 hours for the next 3 days or until the swelling went down.  On 18-Apr-2018, MRI of right shoulder was completed.   On about 31-May-2018, MRI was well a diagnoses her shoulder pain and had partial tear of her right rotator cuff (rotator cuff syndrome) which was referred as 'frozen shoulder' (periarthritis), 1 month 28 days following the administration of DIPHTHERIA-2/TETANUS/5 AC PERTUSSIS VACCINE and PNEUMOVAX 23.   Relevant laboratory test results included: Magnetic resonance imaging - On 18-Apr-2018: patient had partial tear of her right rotator cuff which was referred as 'Frozen shoulder'. (diagnosis done on 31-May-2018)  Final diagnoses were periarthritis, rotator cuff syndrome, pain, mobility decreased, vaccination site pain, extensive swelling of vaccinated limb. It was reported that patient was unable to work from 04-Apr-2018 to 28-feb-2019.   The patient was treated with IBUPROFEN (IBUPROFEN) and Ice packs.   The event outcome was reported as known for all reported events.