Age: 37.0
Sex: F
Vaccine: VARZOS
Symptoms: Streptococcus test negative, Thyroxine normal, White blood cell count normal
Clinical narrative: This case was reported by a consumer via call center representative and described the occurrence of enlargement of lymph nodes in a 37-year-old female patient who received SHINGRIX for prophylaxis.  The patient's past medical history included shingles (1st time at age of 12. When she turned 30, she had Shingles again.), post herpetic neuralgia, heart attack, stroke, nerve damage (severe nerve damage from t3 to c1) and pregnancy (children had chicken pox). Previously administered products included ZOSTAVAX with an associated reaction of herpes zoster. Concurrent medical conditions included occipital neuralgia, trigeminal neuralgia, bell's palsy, anxiety, fibromyalgia, raynauds and migraine. On 24th April 2018, the patient received the 1st dose of SHINGRIX (intramuscular) .5 ml. On 24th April 2018, unknown after receiving SHINGRIX, the patient experienced inappropriate age at vaccine administration. On an unknown date, the patient experienced enlargement of lymph nodes, lymph node pain, swallowing difficult, sore throat, tingling, eye swelling, epstein-barr virus infection, migraine aggravated, nerve pain and condition aggravated. The patient was treated with acyclovir, antibiotics nos (Antibiotics (Brand Names Not Known)) and prednisone. On an unknown date, the outcome of the enlargement of lymph nodes, lymph node pain, swallowing difficult, sore throat, tingling, eye swelling, epstein-barr virus infection, migraine aggravated, nerve pain and condition aggravated were unchanged and the outcome of the inappropriate age at vaccine administration was unknown. It was unknown if the reporter considered the enlargement of lymph nodes, lymph node pain, swallowing difficult, sore throat, tingling, eye swelling, epstein-barr virus infection, migraine aggravated, nerve pain and condition aggravated to be related to SHINGRIX. Additional details were provided as follows: The patient had Shingles about 250 times by now (prior to vaccination of SHINGRIX) and every time she gets pregnant, and when her children had chicken pox. The patient stated she was currently under the age of 50 and she received SHINGRIX in left arm, which led to inappropriate age at vaccine administration. Within 2 months of getting the vaccine, she developed swollen and painful lymph nodes. She currently had 3 lymph nodes. Two lymph nodes were under the chin above the thyroid by the neck which cover the size of 3 inches by 3 inches like a golf ball. One lymph node was on the right side under the jaw by the ear which covers the size of 1 inch by 1 inch like a ping pong ball. This lymph node pushes on her occipital nerve. She mentioned that the lymph node swelling was exacerbating her current nerves. It was worsening her migraines, and she had hard time swallowing due to the lymph nodes pressing on her neck. It was aggravating her nerve in shoulder and collar bone area. In June, 2018 she visited her doctor for swollen lymph nodes, sore throat and exaggeration of her current condition (current nerves and migraine). She was put on antibiotics and prednisone. She had strep throat culture and the test came negative. The antibiotics did not help her. In July and August she went back to her physician for her lymph node swelling since it did not get better. She was also experiencing never burn and tingling on her whole right side of her face, ears, scalp, from neck to left side of her face, back of arms, around ribs and up to chest. She also experienced swelling of her right eye. She mentioned to her physician that she feels like her Shingles was coming back due to nerve burn and tingling, and her physician started her on Acyclovir for longer than 7 days. The acyclovir did not do anything. In September, 2018 she visited her Neurologist and mentioned her symptoms to him. He performed blood test which came back positive for Epstein Barr Virus. The other tests blood count and T4 tests came back normal. Her white blood cell were not elevated. The patient gave permission to contact her health care physician.