Age: 21.0
Sex: F
Vaccine: FLUX, PPV
Symptoms: Red blood cell sedimentation rate increased, Vaccination site cellulitis, Vaccination site erythema, Vaccination site oedema, Vaccination site warmth
Clinical narrative: This case was reported in a literature article and described the occurrence of inflammatory reaction in a 21-year-old female patient who received Influenza vaccine. Co-suspect products included pneumococcal vaccine. Concurrent medical conditions included asthma. On an unknown date, the patient received Influenza vaccine and pneumococcal vaccine. On an unknown date, less than a day after receiving Influenza vaccine, the patient experienced inflammatory reaction (serious criteria hospitalization), body temperature increased and vomiting. On an unknown date, the outcome of the inflammatory reaction, body temperature increased and vomiting were recovered/resolved. It was unknown if the reporter considered the inflammatory reaction, body temperature increased and vomiting to be related to Influenza vaccine. Additional information received: This case was reported in a literature article and it described the occurrence of a systemic inflammatory reaction in a 21-year-old female patient who had received an unspecified Influenza vaccine and an unspecified pneumococcal vaccine (manufacturers unknown). Concomitant medical conditions included asthma, which was the reason for the administration of the pneumococcal vaccine. The patient had not received this vaccine previously. No further information on the patient's concurrent medical conditions, medical and family history or concomitant medication was provided by the authors. On an unspecified date, the patient received and an unspecified Influenza vaccine and unspecified pneumococcal vaccine (dosages unknown; vaccines were administered in opposite arms; batch numbers not provided). On an unspecified date, within 1 day of the administration of the vaccines, the patient developed severe local erythema, oedema and warm at the pneumococcal vaccine administration site to the extent that it was believed to be cellulitis. In addition to this, the patient also suffered an increase in the temperature up to 103.2 deg. F (within 1 day of the vaccination) and vomiting. The local reaction expanded well beyond the injection site by day 3-4 post-vaccination. The patient sought medical attention and was admitted to hospital for observation. Once there she was found to have a leukocytosis with a predominance of neutrophils, as well as elevated erythrocyte sedimentation rate and her C-reactive protein. The patient experienced an improvement in the skin problems and a resolution of the systemic symptoms within 5-7 days, and was eventually discharged home. This was a serious case as the patient required hospitalization. The patient white blood cell count at the time of the event was 20.7 x 10E3/ul, her erythrocyte sedimentation rate was 92 mm/h and her C-reactive protein was 20mg/dl. Treatment was unknown. The outcome of the skin conditions was improvement within 5-7 days. Outcome of the systemic events was resolution with 5-7 days. The authors believed that the reactions were due to the pneumococcal   [Due to memory limitations, the remainder of this text could not be compared.]  ccal vaccine based on its known side effects, the lack of similar findings in patients who received the Influenza vaccine in isolation and this patient's lack of Influenza vaccine-associated local symptoms. The authors concluded "that this case series highlights potential side effects of the pneumococcal vaccine that are not well described in the adult literature. Antibiotics were not helpful in treating these patients' local and systemic symptoms. Patients with histories consistent with that highlighted in this case series may avoid antibiotics and hospitalization if their providers recognize these symptoms as a non-infectious reaction to the pneumococcal vaccine". This case is 1 of the 5 valid cases reported in the same literature article (see case US2015GSK149063).