Age: 32.0
Sex: M
Vaccine: COVID19
Symptoms: Full blood count, Herpes zoster, Insomnia, Lipids, Metabolic function test
Clinical narrative: Shingles; he couldn't sleep; breaking out in a rash on his scalp, chest and neck/ starting to itch/ it was looking less red/ rash felt like a sunburn or if like he was hit with a cactus/ did sting some; breaking out in a rash on his scalp, chest and neck/ starting to itch/ it was looking less red/ rash felt like a sunburn or if like he was hit with a cactus/ did sting some; felt like he had a scratch on his scalp; felt like he had a scratch on his scalp and his wife told him that it looked a little swollen; This is a spontaneous report from a contactable consumer (patient) and pharmacist. A 32-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection), dose 1 intramuscular, administered on the left arm on 04Mar2021 09:45 (also reported as 12:00) (Batch/Lot Number: EN6199) at the age of 32 years old as 1st dose, single for COVID-19 immunisation. Medical history included seasonal allergies (had it his whole life), sore arm and a family history of shingles (he's had an uncle or something that had shingles before but nothing with his parents). The patient had no allergies to medications, food or other products. Concomitant medication included loratadine (CLARITINE) from Feb2021 for seasonal allergies. The patient wanted to know on what he should expect after receiving the second dose of the vaccine and if he was eligible to receive the vaccine. The patient reported side effects on v-safe. He heard from other doctors that shingles had been reported from the first dose of the vaccine. He wanted to know if shingles would impact the antibodies that he may develop post vaccination. The patient stated that the fact sheet indicated that the second dose should be administered 3 weeks after the first dose, he was scheduled to receive the second dose 4 weeks later and wanted to know if it was safe to receive the vaccine outside the of the recommended time frame. The patient stated that he should be trying to take loratadine everyday (usually takes at night before bed) 1 since he does get kind of bad allergies sometimes. On 12Mar2021 (8 days later after the vaccination), the patient was diagnosed with shingles after breaking out in a rash on his scalp, chest and neck. The patient met his doctor and was recommended to report the adverse event. The patient went through CDC V safe and was provided with an information sheet that from Walgreens that listed the number for Pfizer to call if he needed further information. The patient reported that the noticed the rash (present on his scalp, chin, neck and up around his neck on his right side) on 06Mar2021 or 07Mar2021. The patient stated that the rash onset was "two fold". He noticed it when the back of his head on the right side started to become agitated in Mar2021.  He stated that he sleeps with an eye mask on due to block out the lights from the baby monitor for his 6-month-old and originally thought that it was the sleep mask that was bothering him. He mentioned that on 06Mar2021 or 07Mar2021, he felt like he had a scratch on his scalp and his wife told him that it looked a little swollen. He then reported that the rash on his scalp started to get more and more uncomfortable. When the patient came home on 10Mar2021 around 17:00 or 17:30, he removed his shirt and his wife looked at him and asked what it was. He then reported that the rash appeared on his neck and chin and showed up overnight or that morning. He then stated that the rash on his chin and neck was not painful or anything. The patient then stated that the rash on his head was getting pretty agitated as of 10Mar2021. The patient thought that the rash on his chin, neck, and chest was eczema or heat rash, but thought it was odd because heat rash is normally flat. When he woke up on Wednesday (10Mar2021), the rash was looking worse but was still not bothering him except for the rash on his head. He considered going to urgent care on Thursday (11Mar2021) but didn't follow through. On Thursday night to Friday night (11Mar2021 to 12Mar2021), he couldn't sleep. His rash felt like a sunburn or if like he was hit with a cactus, and the rash on his neck started to bother him. The patient went to urgent care on 12Mar2021, and when the nurse practitioner walked in, looked at him and said that it was shingles. The patient saw 3 people at the urgent care, a nurse, nurse practitioner and a resident doctor as a doctor was needed to confirm the diagnosis. All three of the staff members said that the rash was shingles where the rash was following a nerve pattern. The patient used a cream to treat the rash, he mentioned that he tried diphenhydramine HCl 2%, zinc acetate 0.1% (Benadryl Extra Strength Itch Stopping Cream, Topical Analgesic Skin Protectant; Lot 1790LZ/3, Exp: May2022) briefly on the back of his scalp for 1 night as it was starting to itch and feel weird. He mentioned that it did sting some but didn't think anything of it as sometimes the cream will sting when put over a scab. He also used Aquaphor Healing Ointment Baby Advanced Therapy (Exp: Aug2022, UPC: 0 7214063386 8; NART number 63386), taking slabs of it and putting it over the rash. He then stated that neither did anything. After going to the urgent care, he was put on antibiotics (late described as an antiviral that should clear up in 7 to 10 days since he was young and healthy) that day and essentially said there was not much he could do. The staff also recommended that because he had 6-month-old he should call his son's pediatrician but that his infant son should be okay. He followed up with his son's pediatrician and his doctor, who stated that it should be fine, just to minimize contact with his son. The rash was still visible on his chin, neck and chest. On his scalp was harder to see because of his hair. He stated that going on feel, outside of one spot it felt significantly better. He can now wash his hair and lay on that side of his head without pain. The rash on his neck looks like some are starting to scab over.  He reported that not one patch has disappeared yet, but his wife said that it was looking less red and inflamed. His doctor scheduled a routine blood draw for 08Mar2021 during his physical and stated that he was willing to go through test results as he was unsure what would be helpful, but there were numerous results for each lab test (CBC with auto differential, Lipid panel with reflex to direct LDL, Comprehensive metabolic panel, PSA, total, Urinalysis, and Vitamin D (25-hydroxy) total).  He reported that his doctor had sent him a message in the evening on 08Mar2021 that said "results all normal". The patient didn't require a visit to the emergency room but required a visit to physician office. The patient had no prior vaccinations (within 4 weeks). He stated that there was no history of his parents experiencing an adverse event with vaccines, just the usual sore arm, stuff like that. On 19Mar2021, the pharmacist reported that the events were non-serious. The pharmacist reported that the treatment used for the event was famciclovir. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. The outcome of the events pruritic rash and erythematous rash was recovering, for shingles was recovered, while unknown for the other events.  Follow-up attempts are completed. No further information is expected.