Age: 53.0
Sex: F
Vaccine: VARZOS
Symptoms: Influenza virus test negative, Myalgia, Pain, Pain in extremity, Pyrexia
Clinical narrative: accelerated junction rhythm; rapid heart rate /elevated pulse at 130 beats per minute; body ache; muscle pain; arm hurt; shivering / chills; fever; headache; back pain; all teeth hurting; weakness; not feeling steady on feet; felt like / had the flu; This case was reported by a consumer and described the occurrence of accelerated junctional rhythm in a female patient who received Herpes zoster (Shingrix) for prophylaxis.   Previously administered products included Shingrix with an associated reaction of pain in extremity (1st dose received on 31st August 2020, refer case US2020AMR226332).   On 5th November 2020, the patient received the 2nd dose of Shingrix. In November 2020, 12 hrs after receiving Shingrix, the patient experienced accelerated junctional rhythm, heart rate increased, general body pain, muscle pain, pain in arm, shivering, fever, headache, back pain, toothache, weakness, unsteadiness and influenza like illness. The patient was treated with intravenous fluid (nos) (Intravenous Fluids). On an unknown date, the outcome of the accelerated junctional rhythm, heart rate increased, general body pain, muscle pain, pain in arm, shivering, fever, headache, back pain, toothache, weakness, unsteadiness and influenza like illness were unknown.   It was unknown if the reporter considered the accelerated junctional rhythm, heart rate increased, general body pain, muscle pain, pain in arm, shivering, fever, headache, back pain, toothache, weakness, unsteadiness and influenza like illness to be related to Shingrix.  Additional details were provided as follows: The patient received the second dose of the Shingrix vaccine in her right arm and later in the night she had body ache, muscle pain, her arm hurt, shivering, fever, chills, headache, back pain, all teeth hurting, weakness, not feeling steady on feet, felt like she had the flu, rapid heart rate, elevated pulse at 130 beats per minute.  On 6th November 2020, the patient was seen by her physician who did an ECG and documented accelerated junction rhythm, abnormal ECG. Later in the afternoon on 6th November 2020, the patient was seen at the emergency room, since her heart rate had not decreased and in the emergency room she was given a pain medication and IV fluids were given and later in the evening she was discharged.  The bed rest had bought her pulse rate to 80 beats per minute.  But the patient stated that her heart rate and pulse still gets elevated if she walked around and the physician had advised her to rest. At the emergency room, they again did the ECG and it was again reported as accelerated junction rhythm and abnormal ECG. The COVID test was negative, urine test was negative, flu test was negative, CT scan was negative. The physician could not identify the cause of the rapid heart rate. The additional details were provided by the reporter after filing an adverse event. The reporter noted a rapid heart beat that began approximately twelve hours after dose two of Shingrix. The reporter noted rate of 100-120 beats per minute. She noted she can get the rate down if she lies down and remains still, then she can lower it to 80-90 beats per minute. The patient had undergone a chest x-ray, CAT scan and blood work and the reason for the rapid heart beat could not be explained. The reporter did not have lot number or expiration date for the dose she received. The reporter consented to follow up.; Sender's Comments:  US-GLAXOSMITHKLINE-US2020AMR226332:same patient 1st dose