Sex: F
Vaccine: RAB, TDAP
Symptoms: Food allergy, Neuralgia
Clinical narrative: Elevated d-dimer; Right bundle branch block; Food sensitivities; Nerve pain; Chronic constipation; Fatigue; Stomachaches; Heartburn; Declining digestion; Chest pain; Case reference number BN-2021-002493, initially downloaded on 06-Dec-2021, is a spontaneous case received from a consumer via health authority  (Worldwide Unique Identifier 1850730-1) and concerns a 46-year-old female patient.  The patient's current medical condition included chronic dermatitis on neck, which was recently diagnosed as lichen simplex chronicus.  The patient's medical history was not provided.  The patient's concomitant medications included calcium/magnesium, vitamin D, iodine, selenium, spore-based probiotics and penicillin.   On 30-Oct-2019, the patient was vaccinated with a dose of RabAvert (inactivated rabies virus vaccine, batch number was not provided) and with co-suspect Boostrix (diphtheria vaccine toxoid, pertussis vaccine acellular 3-component, tetanus vaccine toxoid; batch number was not provided), both at an unknown dose or route of administration, for unknown indication.  On 24-Dec-2019, approximately two months after the vaccination, the patient experienced severe chest pain on several occasions.  On 29-Jan-2020, approximately two months after the event started, the patient recovered from the event chest pain and went to urgent care to make sure that it was heartburn, and not a heart problem. At that time, the patient was diagnosed with elevated d-dimer and right branch block, and heartburn was confirmed. It was reported that following laboratory findings were conducted: blood tests, heart monitoring and CT scan; but no results were provided. Afterwards, the patient was referred to an internist and tried some supplements, which had limited effects.   It was also reported that the patient weaned off using spore-based probiotics and that the symptoms went away as the probiotics were decreased.   On an unspecified date, reported as spring of 2020, approximately half a year after the vaccination, the patient noticed declining digestion and development of food sensitivities. Symptoms included stomachaches, nerve pain, fatigue and chronic constipation, which continued to the day of this report. The patient controlled other symptoms by a very restricted diet.  The reporter assessed the events as non-serious. Causality assessment was not provided.  No further information was provided.; Reporter's Comments: A 46-year-old female patient was vaccinated with a dose of RabAvert at an unknown dose or route of administration, for unknown indication on 30-Oct-2019. Approximately two months later patient experienced chest pain, and a month after that event the patient was diagnosed with elevated d-dimer and right branch block. On an unspecified date, reported as spring of 2020, approximately half a year after the vaccination, the patient noticed declining digestion and development of food sensitivities, symptoms included stomachaches, nerve pain, fatigue and chronic constipation, Right bundle branch block, chest pain, increased fibrin D-dimer, dyspepsia, food allergen sensitization, nerve pain and chronic constipation are not listed, whilst fatigue and stomachache are listed for RabAvert according to datasheet version 6.0. The patient's medical history was not provided. The patient's concomitant medications included calcium/magnesium, vitamin D, iodine, selenium, spore-based probiotics and penicillin. The patient co-suspect Boostrix can be a confounding factor for all reported events. Due to plausible temporal relationship, but also limited information on circumstances surrounding the event, other possible risk factors and concurrent diseases, the evaluation did not find enough evidence to exclude at least a contributory role of RabAvert in development of all reported events at this moment, therefore causality is assessed as related. The case is non-serious.; Sender's Comments: A 46-year-old female patient was vaccinated with a dose of RabAvert at an unknown dose or route of administration, for unknown indication on 30-Oct-2019. Approximately two months later patient experienced chest pain, and a month after that event the patient was diagnosed with elevated d-dimer and right branch block. On an unspecified date, reported as spring of 2020, approximately half a year after the vaccination, the patient noticed declining digestion and development of food sensitivities, smptoms included stomachaches, nerve pain, fatigue and chronic constipation, Right bundle branch block, chest pain, increased fibrin D-dimer, dyspepsia, food allergen sensitization, nerve pain and chronic constipation are not listed, whilst fatigue and stomachache are listed for RabAvert according to datasheet version 6.0. The patient's medical history was not provided. The patient's concomitant medications included calcium/magnesium, vitamin D, iodine, selenium, spore-based probiotics and penicillin. The patient co-suspect Boostrix can be a confounding factor for all reported events. Due to plausible temporal relationship, but also limited information on circumstances surrounding the event, other possible risk factors and concurrent diseases, the evaluation did not find enough evidence to exclude at least a contributory role of RabAvert in development of all reported events at this moment, therefore causality is assessed as related. The case is non-serious.