Sex: M
Vaccine: COVID19, PPV
Symptoms: Vaccination site rash, Vaccination site warmth
Clinical narrative: Hyperhidrosis/full body sweats; Pain/body aches; Pyrexia/the patient developed a fever up to 103.7; Rash/rash spread across the left arm; Rash erythematous/a large red, warm and tender rash appeared on left deltoid spreading circumferentially medially; Injection site rash/a large red, warm and tender rash appeared on left deltoid spreading circumferentially medially; Injection site warmth/a large red, warm and tender rash appeared on left deltoid spreading circumferentially medially; Chills; Headache/pressure headache; This is a spontaneous report received from contactable reporter(s) (Consumer or other non HCP). Other Case identifier(s): 2023NVX-US-000001266 (Novavax).  A 33-year-old male patient received bnt162b2 omi xbb.1.5 (COMIRNATY (2023-2024 FORMULA)), on 19Sep2023 as dose 1, single (Lot number: HH7595) intramuscular, in left deltoid for covid-19 immunisation; pneumococcal vaccine polysacch 23v (PNEUMOVAX 23), on 19Sep2023 as dose 2, single (Lot number: X019273) intramuscular for immunisation. The patient's relevant medical history included: "Hypertension" (ongoing); "Hyperlipidaemia" (ongoing); "Gastrooesophageal reflux disease" (ongoing); "Back pain" (ongoing); "Post-traumatic stress disorder" (ongoing); "Anxiety" (ongoing); "Depression" (ongoing); "Drug hypersensitivity" (ongoing); "Nonalcoholic fatty liver disease" (unspecified if ongoing), notes: pt hx of Nonalcoholic fatty liver disease. Concomitant medication(s) included: INFLUENZA taken for immunisation, in Aug2023; PREDNISONE ACETATE, stop date: 29Aug2023; CLONIDINE HYDROCHLORIDE (ongoing); PROPANOLOL [PROPRANOLOL]; LISINOPRIL (ongoing); PRAZOSIN; HYDROXYZINE; VITAMIN D3 (ongoing); MAGNESIUM GLYCINATE; ACETAMINOPHEN; DIPHENHYDRAMINE oral; OMEPRA. Vaccination history included: Covid-19 vaccine (Dose 1), for Covid-19 immunization; Covid-19 vaccine (Dose 2), for Covid-19 immunization; Covid-19 vaccine (Dose 3), for Covid-19 immunization; Covid-19 vaccine (Dose 4), for Covid-19 immunization. The following information was reported: CHILLS (non-serious) with onset 20Sep2023, outcome "unknown"; HEADACHE (non-serious) with onset 20Sep2023, outcome "unknown", described as "Headache/pressure headache"; VACCINATION SITE RASH (non-serious) with onset 20Sep2023, outcome "unknown", described as "Injection site rash/a large red, warm and tender rash appeared on left deltoid spreading circumferentially medially"; VACCINATION SITE WARMTH (non-serious) with onset 20Sep2023, outcome "unknown", described as "Injection site warmth/a large red, warm and tender rash appeared on left deltoid spreading circumferentially medially"; RASH ERYTHEMATOUS (non-serious) with onset 20Sep2023, outcome "unknown", described as "Rash erythematous/a large red, warm and tender rash appeared on left deltoid spreading circumferentially medially"; RASH (non-serious) with onset 20Sep2023, outcome "unknown", described as "Rash/rash spread across the left arm"; PYREXIA (non-serious) with onset 22Sep2023, outcome "unknown", described as "Pyrexia/the patient developed a fever up to 103.7"; HYPERHIDROSIS (non-serious), outcome "unknown", described as "Hyperhidrosis/full body sweats"; PAIN (non-serious), outcome "unknown", described as "Pain/body aches". Relevant laboratory tests and procedures are available in the appropriate section. Therapeutic measures were taken as a result of pyrexia. Additional information: About 26 hours after vaccination a large red, warm and tender rash appeared on left deltoid spreading circumferentially medially. Associated symptoms included chills, rigors, body aches and pressure headache in the frontal and occipital areas. About 36 hours after vaccination the patient developed a fever up to 103.7. Initial treatments included 1000 mg of acetaminophen. Fever did not break and was followed by 400 mg ibuprofen. The patient developed full body sweats. The patients rash spread across the left arm only. The next day the fever cycle continued to a temperature max of 104.7 F. The patient saw his local urgent care nurse practitioner who recommended alternating acetaminophen and ibuprofen as dosages above not to exceed 3000 mg (pt hx of Nonalcoholic fatty liver disease) of acetaminophen and 1200 mg of ibuprofen in 24 hours. A warm compression the rash area as well as diphenhydramine oral or topical was recommended.