Age: 67.0
Sex: F
Vaccine: FLU3, PPV, FLUX, PPV, FLU3, PPV
Symptoms: Computerised tomogram head normal, Full blood count normal, Hemiparesis, Metabolic function test normal, Nuclear magnetic resonance imaging brain normal
Clinical narrative: On Thursday, September 22, 2016, my husband and I went to our local pharmacist to have our over 65, high dose flu shot and our recommended second and final pneumococcal vaccination. We filled out the paperwork at pharmacy and waited for our regular pharmacist to administer our inoculations. At about 12:30 we were individually called in, my husband first and then myself. Because I am right handed, I requested having the flu shot in my left arm and the pneumonia shot in my right. Then we were off to run a day filled with errands. Shortly after receiving these I did ask my husband if the arm that he received the pneumonia shot was hurting, he said no, but mine became warm, painful and sensitive to the touch, fairly early on. I did not put much thought to this, since I have had moderate discomfort associated with these annual shots in the past. On the second to the last stop, around 5:00 in the afternoon, I told my husband that I would wait in the car as I was feeling a bit tired, but attributed it to all the running around. At our last stop, I was feeling flush and since it was a quick run into store for him, I opted to wait in the truck. Within moments of his leaving, my right leg began to shake uncontrollable and then the movement progressed up that side to my head and then within minutes had become a full body, involuntary flaying, for lack of a better descriptive word. I called my husband on the cell phone and the violent shaking was making it very difficult for me to speak, but he clearly realized that there was a problem and returned to the truck immediately. We were within 15 minutes of a local hospital and he opted to take me there. At admission, they immediately put in an IV and then transported me to an emergency room for evaluation. I was given BENADRYL as an attempt to quell the body movements, but it had little, if any affect. A CT scan was done while in the emergency room, because as I was told by the attending ER physician and first neurologist, they had never seen this sort of a reaction to either a flu or pneumonia shot. The CT scan came back clean, no brain bleeds, but it was decided that I needed to stay overnight for observation. I was transferred to a general room and around 2:00 am I was transferred to an upper floor and put on stroke protocol. This required hourly monitoring: hold your arms out straight in front of you, lift up your legs, touch your finger to Dr or nurse finger and then your nose, run one foot up the leg/shin of other leg. Unfortunately, none of these actions were accomplished because of the non-stop shaking and weakness in all extremities. I was also running a fever that the night nurse worked diligently to bring down. At about 10:00 p.m. I developed a 7-7.5 pain level headache, most likely because I was only receiving IV fluids, nothing by mouth until my discharge late Friday, 9/23/16. No medications for pain could be administered until Friday. An EKG was done on Friday morning, all ok, and an MRI was done early Friday afternoon and that too showed no evidence of a likely cause for the tremors. After medications were administered for the headache and claustrophobia in MRI machine, the symptoms seemed to subside. I was able to do all the requested "stroke protocol" body movements. By late afternoon, the involuntary shaking went from intermittent to stopping, so at my request, I was discharged. I had spoken to several neurologists and while they had not seen this type of inoculation reaction before, they did assure me that it was not stroke related and informed me that they would be reporting it to the CDC and were comfortable sending me home. Thru the weekend, the tremors and interrupted (halted) speech came and went. On Saturday night my body pain was so severe that I commented to my husband, "it even feels like my kidneys are hurting". My husband took off from his job the next week to stay with me and drove me to the required follow up appointment with our primary physician, at the clinic, on Monday, 9/26/16. Dr. observed the subtle head movement, right hand tremor and slight unbalance in walking. The, as he described it, "halted/interrupted speech", was also evident at this appointment. As noted on your form, he did prescribe 0.5 mg Lorazepam to be taken as needed three times per day. This has helped and I was also told that I could cut the pills in half as they were making me feel drowsy. Due to circumstances, I also was able to speak to the pharmacist in person to assist him in completing his required reporting paperwork. The symptoms are currently under control, for the most part, occurring intermittently. The most problematic being the issues as related to speech. However, neither my husband or I are thrilled at the prospect of having to take this medication indefinitely, but we also are hoping that in time, the medication could dissipate in my body and the symptoms would diminish. Sorry that this has become such a lengthy explanation, but I just don't want this to happen to anyone else if possible. Not only was it unnerving for me as the patient, but it also caused unnecessary concern to my husband and family. I believe that I have requested reporting information from the agency, but to date, I have not received a response from that agency.