Sex: F
Vaccine: FLU4, PPV, PPV
Symptoms: Arthralgia, Chills, Fatigue, Flank pain, Headache
Clinical narrative: muscle aches; injection site soreness; blotchy, flat rash on my left shoulder above the injection site; joint ache; dull headache that was light and sound sensitive; tingling in the right fingertips of the thumb, pointer and median half of the middle finger; exhaustion; slept for a bulk of the day; body ache; low-grade fever with chills; injection site was incredibly uncomfortable; to the point that I was not able to use my left arm; tingling numb; My toes were "cold" feeling; my lips changed to a much lighter pink; low-grade fever with chills; This spontaneous report was received from a female patient in her 30's reporting on herself.  No information was provided regarding the patient's medical history, concurrent conditions, past drug history or concomitant medications.  On Saturday 19-SEP-2020, at approximately 12:00, the patient was vaccinated with pneumococcal vaccine, polyvalent (23-valent) (PNEUMOVAX23) 0.5ml syringe, for prophylaxis (dose, route and site of administration, lot number and expiration date were not reported).  Concomitant therapies included influenza virus split virion 4v vaccine inactivated (FLUARIX QUADRIVALENT).     On that night, the patient experienced an onset of symptoms including low-grade fever (pyrexia) with chills (chills) (101.8F) and the injection site was incredibly uncomfortable (injection site discomfort) to the point that she was not able to use her left arm (injected limb mobility decreased). Her toes additionally were 'cold' feeling (peripheral coldness) and that border of tingling numb (hypoaesthesia), and her lips changed to a much lighter pink (pallor).   On Sunday 20-SEP-2020, the patient still had fever, body ache (pain), joint ache (arthralgia), a dull headache that was light and sound sensitive (headache), chills on and off, tingling in the right fingertips of the thumb, pointer, and median half of the middle finger intermittently (paraesthesia). She had exhaustion (fatigue) and slept for a bulk of the day (over 12 hours) (somnolence).  On Monday 21-SEP-2020, the patient remained feverish with headache, had chills but not as violently ("it was more steady-state"), tingling in the right fingertips of the thumb, pointer, and median half of the middle finger (upper digit, ventral side) was also felt intermittently, also had exhaustion and slept for approx. 20 hours. On Tuesday or Monday late, the patient did not have a fever, her temperature returned back down to 96-98F range, but the headache persisted until roughly 6PM when it gradually tapered off. She also had muscle aches (myalgia), injection site soreness (injection site pain), tingling in the right hand as described above, and then the addition of a blotchy, flat rash on my left shoulder above the injection site (injection site rash).  It was unknown if any laboratory test was performed.  The outcome of peripheral coldness, injection site rash, injection site pain, myalgia, fatigue, paraesthesia, arthralgia, injected limb mobility decreased, injection site discomfort, chills, pain, hypoaesthesia, somnolence and pallor was unknown. The outcome of headache was reported as recovering. The outcome of pyrexia was reported as recovered.   The patient sought medical attention and consulted her medical provider who ruled out the flu vaccine and suspected the patient had an adverse reaction to the pneumococcal vaccine, polyvalent (23-valent) (PNEUMOVAX23) injection.