Age: 87.0
Sex: F
Vaccine: VARZOS, VARZOS
Symptoms: Injection site pain, Muscle spasms
Clinical narrative: could not move wrist/not able to move left arm; pseudogout; pain at injection site radiating to breast area./pain started really great (intense); pain at injection site radiating to breast area./pain started really great (intense); teeth chattering; pain at injection site; First injection date unknown maybe early spring or February 2020.; trouble forming words.; Muscle spasm; she can't remember all the details; This case was reported by a pharmacist via call center representative and described the occurrence of pseudogout in a 87-year-old female patient who received Herpes zoster (Shingrix) (batch number 4RF5J, expiry date 25th April 2022) and (batch number 57EE5, expiry date unknown) for prophylaxis.   Previously administered products included Shingrix (received 1st dose on an unknown date, might be early spring or February 2020).   On 10th September 2020, the patient received the 2nd dose of Shingrix (intramuscular). On 10th September 2020, unknown after receiving Shingrix, the patient experienced drug dose administration interval too long. On 12th September 2020, the patient experienced pseudogout (serious criteria hospitalization), radiating pain (serious criteria hospitalization), breast pain (serious criteria hospitalization) and injection site pain. On 13th September 2020, the patient experienced injected limb mobility decreased (serious criteria hospitalization). In September 2020, the patient experienced word finding difficulty, muscle spasm and memory impairment. On an unknown date, the patient experienced teeth chattering. The patient was treated with naproxen. On an unknown date, the outcome of the pseudogout, radiating pain, breast pain, word finding difficulty, muscle spasm, teeth chattering, memory impairment and drug dose administration interval too long were unknown and the outcome of the injected limb mobility decreased and injection site pain were not recovered/not resolved.   It was unknown if the reporter considered the pseudogout, radiating pain, breast pain, injected limb mobility decreased, injection site pain, word finding difficulty, muscle spasm, teeth chattering and memory impairment to be related to Shingrix.  Additional details were provided as follows: The patient received 2nd dose of Shingrix later than the recommended schedule which led to lengthening of vaccination schedule. The patient received Shingrix in left deltoid.  After receiving Shingrix, the patient experienced pain at injection site radiating to breast area.  The pain started really great (intense) then went away then came back on 13th September 2020, Sunday morning.  The patient called ambulance and could not move wrist.  The patient was in ER all day on Sunday, 13th September 2020.  ER doctor diagnosed her with pseudogout.  The patient was treated for pain all day Sunday, 13th September 2020.  The patient was given option to stay in hospital or be discharged, she stayed for 2 days.  Her pain was so great she could not remember all the details of her hospital stay.  The patient had trouble forming words.  The patient was given Naproxen when discharged.  The patient also experienced muscle spasm and teeth chattering.  She needed physical therapy. At the time of reporting, the patient was still not able to move left arm. The reporter consented to follow up.