Age: 71.0
Sex: M
Vaccine: COVID19
Symptoms: Blister, Herpes zoster, Pain, Pruritus
Clinical narrative: Hand broke down with almost herpes zoster; Hurt / painful; blistery; itchy; This is a spontaneous report based on information received by Pfizer (manufacturer control number: MOD21-159769).   This 71-year-old male physician (patient) reported for himself. It was specified that the patient received Moderna, his third shot. First two doses were BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE).   The patient reported that two days after the Moderna (lot number 058E21A) third, booster dose on 07Sep2021, he got short of breath. Day number 4, he got hypotensive, short of breath, and a cough. Day number 5, he had chest pain and was admitted into the emergency room with myocarditis and bilateral pneumonia and ground glass infiltrates.  The patient is a retired immunologist with rheumatoid arthritis. He got two doses of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) on 01Feb2021 and 24Feb2021. His hand broke down with almost herpes zoster: it really hurt, blistery, painful, and itchy. He was on methotrexate. He decided to stop the methotrexate and all his immunosuppressants.   On 07Sep2021, he got the Moderna third dose (lot 058E21A). Two days after on 09Sep2021, he had tachypnea and cough and flu-like symptoms. On 10Sep2021, he got hypotensive, more shortness of breath, more cough. Oxygen started to go down, but not below 88. On 11Sep2021, his heart hurt. He really had a hard time breathing, so he called the ambulance and brought Anakinra with him. He had an MI in 2008, so he knows what it feels like. He also had pericarditis. He went to the emergency room on 11Sep2021. He had ground glass infiltrates and bilateral pneumonia. His EKG looked like he had a heart attack, and his troponin was 22. He was given Solu-Medrol, and he felt better. He was given doxycycline 100 mg twice a day. He was in the hospital for 6 days; his oxygen improved. He did a 6-minute walk test, and then he was fine. His chest hurt; heart rate went up to 135 with his pacemaker. Then he took his shot of Anakinra. He talked to the head of infectious disease, who said he had COVID, but he tested negative for COVID twice. His IgG to nucleocapsid protein was negative. His spike protein was 2700. His d-dimer was elevated, kidneys were messed up. His blood sugar was way up, so he had to take insulin. He states this looked a lot like COVID. After 5 days of Anakinra, his oxygen with walking briskly became normal and heart rate didn't go over 100. He was discharged from the hospital on 16Sep2021. His chest x-ray improved, and he has a high resolution CT scan scheduled next month. The physician states that he also reported this elsewhere (he forgot the report site). He added that he had maculopapular rash in the hospital, which responded to topical steroids. Consent given for safety to contact the physician and his primary and cardiologist.  Cardiac related signs and symptoms: Precordial chest pain, achiness, but no radiation, in the center of his chest. Pleuritic chest pain, but probably from the pneumonia. It hurt if he took a deep breath. QT interval increased, so he had to go off of dofetilide for a few days. He had a-fib in the hospital. The symptoms started in mild on 09Sep2021 and increased by 11Sep2021 to the point he needed to call an ambulance. The symptoms resolved on 21Sep2021. Treatment: initially it was Solu-Medrol 125 mg in the emergency room, then IV doxycyline and followed up with doxycycline. In the hospital, heparin shots for three days. He also took Anakinra for 10 days. He took insulin because his sugar level was high. He was treated with topical steroid in the hospital for his rash. There was not a history of COVID-19 infection. There was a history of pericarditis. He had an ablation in 2016 for atrial fibrillation, which resulted in hemorrhagic tamponade. Clinical outcome: almost a full recovery. The chest x-rays improved.  Relationship with the vaccine dose, after the 1st or the 2nd dose?: Third dose of Modema. Was a cause determined? he thinks it's in response to Moderna.  Have you experienced symptoms like this before receiving the Moderna COVID-19 vaccine? No  The lot number for BNT162B2, was not provided and will be requested during follow up.