Age: 69.0
Sex: F
Vaccine: VARZOS, VARZOS
Symptoms: Rash vesicular, White blood cell count normal
Clinical narrative: Chills / chills which weren't present within the first 30 hours; Head, skull and neck pain / severe neck pain; Pain while moving eyes; Sweating; nerve pain going down both of her legs, and sensitive nerve pain in shoulder blade and back area; Increased double vision; sensitive nerve pain in shoulder blade; dehydration; pain she is experiencing; Spine pain; Redness at injection site; Swollen arm; Hot arm; Fever under 100 degrees / went up to 102.4 degrees; Malaise; severe head/pain in skull; This case was reported by a other health professional via call center representative and described the occurrence of injection site erythema in a 69-year-old female patient who received Herpes zoster (Shingrix) (batch number N2E73, expiry date 19th March 2022) for prophylaxis.   The patient's past medical history included shingles (previous shingles sufferer from years ago). Concurrent medical conditions included hashimoto's disease and double vision.   On 26th January 2020, the patient received the 2nd dose of Shingrix (intramuscular). On 26th January 2020, less than a day after receiving Shingrix, the patient experienced injection site erythema, swelling arm, extremities hot feeling of, fever, malaise and headache. On 7th February 2020, the patient experienced chills, neck pain, painful eye movement, sweating, nerve pain, double vision, sensitive skin, dehydration, shoulder pain and pain in spine. On an unknown date, the outcome of the injection site erythema, swelling arm, extremities hot feeling of, fever, malaise and headache were recovered/resolved and the outcome of the chills, neck pain, painful eye movement, sweating, nerve pain, double vision, sensitive skin, dehydration, shoulder pain and pain in spine were unknown.   It was unknown if the reporter considered the injection site erythema, swelling arm, extremities hot feeling of, fever, malaise, headache, chills, neck pain, painful eye movement, sweating, nerve pain, double vision, sensitive skin, dehydration, shoulder pain and pain in spine to be related to Shingrix.  Additional details were provided as follows: The patient received Shingrix vaccine and experienced redness at injection site, swelling and hotness on arm, along with fever under 100 degrees, malaise and headache. This events lasted for total of 30 hours. The patient experienced chills in evening, fever that went up to 102.4 degrees, pain in head, skull and neck, pain while moving eyes, sweating, nerve pain going down both of her legs, and sensitive nerve pain in shoulder blade and back area. The patient weared prism glasses for double vision, and her issue with double vision also increased.  The patient also experienced skin sensitivity and nerve/spine pain down her leg, sweating and dehydration. The patients first visit was on 8th February 2020 after her systemic symptoms. The chills which weren't present within the first 30 hours more. The patient went to emergency room yesterday due to the adverse events she was experiencing. The patient went through lumbar puncture test, influenza screening and ct scan. All her results were normal.  Patient reported that she felt relief when they took 4ml of spinal fluid during lumbar puncture as she felt congested in the cerebrospinal area (spine,neck, head).  The patient was a previous shingles suffer from years ago and remembers the scapular/shoulder pain and the pain she was experiencing feels like that but she has no rash.  The patient had a history of Hashimotos.