Age: 53.0
Sex: M
Vaccine: COVID19
Symptoms: Anxiety, Blood pressure measurement, Body temperature, Heart rate, Pain
Clinical narrative: urticaria with overlying excoriations on back of neck and upper back , upper chest and forearms bilaterally; the itching sensation became painful and distracting; the itching sensation became painful and distracting; Red hives on forearms, upper back, upper chest and buttocks; urticaria" from an allergic reaction; very itchy first on scalp, then on torso, arms/hands, buttocks and upper thighs; Itchy rash; This spontaneous case was reported by a consumer and describes the occurrence of PRURITUS (very itchy first on scalp, then on torso, arms/hands, buttocks and upper thighs), SKIN ABRASION (urticaria with overlying excoriations on back of neck and upper back , upper chest and forearms bilaterally), PAIN (the itching sensation became painful and distracting), ANXIETY (the itching sensation became painful and distracting) and URTICARIA (Red hives on forearms, upper back, upper chest and buttocks) in a 53-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 939909, 032L20A and 025J20-2A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below.     The patient's past medical history included Urticaria (15 or so years ago), Anaphylaxis (15 or so years ago) and Endoscopy (Upper endoscopy under general anesthetic.) on 19-Nov-2021. Previously administered products included for Urticaria: epinephrin (15 or so years ago); for Anaphylaxis: epinephrin (15 or so years ago). Past adverse reactions to the above products included No adverse event with epinephrin and epinephrin. Concurrent medical conditions included Allergy to animal dander, Allergic asthma and Allergy to plants.   On 15-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 15-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 20-Nov-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 30-Nov-2021, the patient experienced PRURITUS (very itchy first on scalp, then on torso, arms/hands, buttocks and upper thighs) and RASH PRURITIC (Itchy rash). On 01-Dec-2021, the patient experienced SKIN ABRASION (urticaria with overlying excoriations on back of neck and upper back , upper chest and forearms bilaterally), PAIN (the itching sensation became painful and distracting), ANXIETY (the itching sensation became painful and distracting), URTICARIA (Red hives on forearms, upper back, upper chest and buttocks) and URTICARIA (urticaria" from an allergic reaction). The patient was treated with PREDNISONE (ORASONE) (oral) for Urticaria, at a dose of 20 milligram; HYDROXYZINE PAMOATE (oral) for Urticaria, at a dose of 25 milligram, primarily at night and DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]) for Urticaria, at a dose of primarily at night. At the time of the report, PRURITUS (very itchy first on scalp, then on torso, arms/hands, buttocks and upper thighs) had not resolved, SKIN ABRASION (urticaria with overlying excoriations on back of neck and upper back , upper chest and forearms bilaterally), PAIN (the itching sensation became painful and distracting) and ANXIETY (the itching sensation became painful and distracting) outcome was unknown, URTICARIA (Red hives on forearms, upper back, upper chest and buttocks) and RASH PRURITIC (Itchy rash) was resolving and URTICARIA (urticaria" from an allergic reaction) had resolved.      DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 01-Dec-2021, Blood pressure measurement: 113/76 (Low) 113/76 (BP Location: Left arm, in patient's sitting position and cuff size was alrge adult). On 01-Dec-2021, Body temperature: 98.7 (normal) 98.7 degree fahrenheit or 37.1 degree celcius. (Oral). On 01-Dec-2021, Heart rate: 103 (normal) 103. On 01-Dec-2021, Respiratory rate: 16 (normal) 16.     For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments.   The day after the vaccination everything fine and there were no concerns.  Patient had no history of allergy to any medication.  Patient received allergy shots for environmental allergens, such as trees, cats, and dogs for more than 16 years and patient at maintenance. Early in my program of allergy shots (15 or so years ago)  Urticaria had been successful in sharply reducing the hives and itching, but as of 05-Dec-2021, patient had still itchy.  Skin without oozing or drainage. The patient was pleasant, alert, oriented, no acute distress and event was with unknown trigger. Patient reciving benadryl, which helps a little. Prednisone taper (which patient has tolerated well in the past), benadryl or hydroxyzine (primarily at night) until sx subside. If no improvement with today's care plan, patient will follow up with allergist.  The patient was treated with VISTARIL(hydroxyzine pamoate)