Sex: F
Vaccine: VARZOS
Symptoms: Disease recurrence, Herpes zoster, Mobility decreased
Clinical narrative: Shingles; could not get out of the couch for 3 days; This case was reported by a consumer via call center representative and described the occurrence of shingles in a 67-year-old female patient who received Herpes zoster (Shingrix) for prophylaxis.   Co-suspect products included mepolizumab (Nucala) solution for injection in pre-filled pen for asthma and mepolizumab autoinjector device (Nucala Autoinjector Device) administration system (batch number unk, expiry date unknown) for asthma.   The patient's past medical history included shingles (had one episode at very young and 2 episodes before Nuacala) and blood immunoglobulin g decreased. Concurrent medical conditions included asthma, rheumatoid arthritis (had taken medicines for 7 years), immunocompromised, iga decreased, blood immunoglobulin e decreased and loss of b-cell aplasia. Concomitant products included rituximab (Rituxan).   On an unknown date, the patient received the 1st dose of Shingrix (intramuscular). On 24th June 2021, the patient started Nucala (subcutaneous) 100 mg (see dose text) and Nucala Autoinjector Device. On 6th December 2021, unknown after receiving Shingrix and 165 days after starting Nucala and Nucala Autoinjector Device, the patient experienced shingles. On an unknown date, the patient experienced mobility decreased. The patient was treated with valaciclovir hydrochloride (Valtrex). Nucala was discontinued on 16th November 2021 (Dechallenge was unknown). On an unknown date, the outcome of the shingles was unknown and the outcome of the mobility decreased was recovered/resolved.   It was unknown if the reporter considered the shingles and mobility decreased to be related to Shingrix, Nucala and Nucala Autoinjector Device. This report is made by GSK without prejudice and does not imply any admission or liability for the incident or its consequences.  Additional details were provided as follows: The case was reported by patient herself. The age at vaccination was not reported. The patient was immune suppressed and low low IgG but now it was better, low IgA, and low IgE and had no B cells. The patient had Shingles 4 times in her lifetime, one episode when she was very young and 2 episodes before she started Nucala.  She had rheumatoid arthritis(RA) and had taken medicines for 7 years and had been on Rituxin IV medication 4 times a year for RA. On 24th June 2021, patient with Asthma started taking Nucala SC AI 100 mg/ml once a month.  On 6th December 2021, patient was diagnosed with Shingles. The patient reported she had Shingles only once since she started Nucala and stopped Nucala. She took her last dose on 16th November 2021.  The patient was prescribed Valtrex prophylactically.   The patient missed her Nucala dose on December 2021 and January 2022. The patient reported she had only one dose of Shingrix vaccine and reacted so badly, so that she could not get out of the couch for 3 days. The patient stated that her health care professional performed a test to check the antibodies for shingles and it was very high, so they recommended not to take the second dose of Shingrix. The patient did not provide the date of her 1st dose of Shingrix. Agent attempted to contact patient to obtain the date of Shingrix vaccination, but patient was not available. Lot and expiration dates of both medication are unknown. The reporter did not consent to follow-up.