Age: 60.0
Sex: F
Vaccine: TDAP, VARZOS
Symptoms: Cellulitis, Chest discomfort, Computerised tomogram abnormal, Discomfort, Dysphagia
Clinical narrative: pain/ excruciating pain in upper left collarbone/ General body pain; heaviness in chest; lymphangitis; cellulitis; difficulty to swallow; inflammation in collarbone; lump in collarbone; lump in collarbone; Pain in jaw; shoulder pain; neck pain; shortness of breath; This case was reported by a consumer via sales rep and described the occurrence of lymphangitis in a 60-year-old female patient who received Herpes zoster (Shingrix) for prophylaxis.   Co-suspect products included DTPa (Reduced antigen) (Tdap Vaccine) for prophylaxis.   The patient's past medical history included temporomandibular joint syndrome (pain was very diffrent), spinal column injury (spinal trauma due to a ski accident) and vocal cord dysfunction. Previously administered products included Zostavax (received 2 years before from the date of reporting without incident), tetanus vaccine, flu vaccine (multiple times) and pneumococcal vaccines (without any reaction).   On 24th June 2019 15:00, the patient received the 1st dose of Shingrix and Tdap Vaccine. In June 2019, less than a day after receiving Shingrix and Tdap Vaccine, the patient experienced lymphangitis (serious criteria GSK medically significant), cellulitis (serious criteria GSK medically significant), inflammation localized, swelling, erythema, jaw pain, shoulder pain and neck pain. In June 2019, the patient experienced chest heaviness, shortness of breath and swallowing difficult. On 24th June 2019, the patient experienced pain. The patient was treated with ibuprofen and antibiotics nos. On an unknown date, the outcome of the lymphangitis, cellulitis, pain, chest heaviness, swallowing difficult, inflammation localized, swelling, erythema, jaw pain, shoulder pain and neck pain were unknown and the outcome of the shortness of breath was recovered/resolved.   It was unknown if the reporter considered the lymphangitis, cellulitis, pain, chest heaviness, shortness of breath, swallowing difficult, inflammation localized, swelling, erythema, jaw pain, shoulder pain and neck pain to be related to Shingrix and Tdap Vaccine.  Additional details were provided as follows: The patient received Shingrix in left deltoid and a dose of Tdap (brand not known) in right deltoid at her physician office.  After the injections, she went about her usual routine and experienced some pain that evening and took ibuprofen at bedtime for pain.  About 1 to 2am, she awoke with excruciating pain in upper left collarbone and felt heaviness/tightness in chest and some shortness of breath.  The patient took additional ibuprofen for the pain at that time and found it difficult to swallow the ibuprofen pills, using bread and additional water to help get the ibuprofen down.  Later that morning, upon waking, the day after vaccination, the patient noticed a lump of inflammation at her collarbone on the left side and described it as red, very painful, and about 3 inches circumference and 2inches deep.  The patient no longer had shortness of breath, but did have soreness in jaw and shoulder and pain in neck. She described it as feels like a collar around my neck. The patient took ibuprofen every 6 hours for the pain and discomfort and body aches, and about 4pm, she went to urgent care regarding the lump in her collarbone to investigate if it was maybe a clot. At urgent care, a CAT scan of the area was performed and there was no clot and she received a diagnosis of cellulitis and lymphangitis and was prescribed antibiotic therapy.  The patient stated that the physician couldn't say if it was from the shot but maybe. He said that trauma could have caused the inflammation and then resulted in the cellulitis.  The patient was currently continuing to take ibuprofen for the pain and antibiotics as prescribed.  The patient was due for a re-check of the area in the coming days.