Age: 82.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Pruritus, Psoriasis, Skin exfoliation, Skin fragility
Clinical narrative: Then, my left arm started to get red, swollen, and itchy, mostly in the left arm; Patient explained that by scratching it, the skin became fragile and started bleeding in some areas; The surface of the left arm is stiff and fragile and starting to flake off; He also researched and saw a picture of eczema, and recalls that his doctor had told him that he had Psoriasis in his scalp and thought it was that but it didn't match it; Then, my left arm started to get red, swollen, and itchy, mostly in the left arm; The surface of the left arm is stiff and fragile and starting to flake off; The surface of the left arm is stiff and fragile and starting to flake off; Then, my left arm started to get red, swollen, and itchy, mostly in the left arm; I had local sensitivity for a day or two after the shot in my left shoulder upper arm. " Patient explained that this was longer then what he felt with the first ones and that it it last only one day with a previous dose where it was a little sore; This spontaneous case was reported by a patient and describes the occurrence of PAIN IN EXTREMITY (I had local sensitivity for a day or two after the shot in my left shoulder upper arm. " Patient explained that this was longer then what he felt with the first ones and that it it last only one day with a previous dose where it was a little sore), PERIPHERAL SWELLING (Then, my left arm started to get red, swollen, and itchy, mostly in the left arm), HAEMORRHAGE (Patient explained that by scratching it, the skin became fragile and started bleeding in some areas), MUSCULOSKELETAL STIFFNESS (The surface of the left arm is stiff and fragile and starting to flake off) and PSORIASIS (He also researched and saw a picture of eczema, and recalls that his doctor had told him that he had Psoriasis in his scalp and thought it was that but it didn't match it) in an 82-year-old male patient who received mRNA-1273.815 (SPIKEVAX 2023-2024) (batch no. AU39193) for COVID-19 prophylaxis. The occurrence of additional non-serious events is detailed below.     The patient's past medical history included Peripheral arterial disease (blockage in legs).    On 01-Nov-2023, the patient received fifth dose of mRNA-1273.815 (SPIKEVAX 2023-2024) (unknown route) 1 dosage form. In November 2023, the patient experienced PAIN IN EXTREMITY (I had local sensitivity for a day or two after the shot in my left shoulder upper arm. " Patient explained that this was longer then what he felt with the first ones and that it it last only one day with a previous dose where it was a little sore). On an unknown date, the patient experienced PERIPHERAL SWELLING (Then, my left arm started to get red, swollen, and itchy, mostly in the left arm), HAEMORRHAGE (Patient explained that by scratching it, the skin became fragile and started bleeding in some areas), MUSCULOSKELETAL STIFFNESS (The surface of the left arm is stiff and fragile and starting to flake off), PSORIASIS (He also researched and saw a picture of eczema, and recalls that his doctor had told him that he had Psoriasis in his scalp and thought it was that but it didn't match it), ERYTHEMA (Then, my left arm started to get red, swollen, and itchy, mostly in the left arm), SKIN FRAGILITY (The surface of the left arm is stiff and fragile and starting to flake off), SKIN EXFOLIATION (The surface of the left arm is stiff and fragile and starting to flake off) and PRURITUS (Then, my left arm started to get red, swollen, and itchy, mostly in the left arm). The patient was treated with DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]) at an unspecified dose and frequency. At the time of the report, PAIN IN EXTREMITY (I had local sensitivity for a day or two after the shot in my left shoulder upper arm. " Patient explained that this was longer then what he felt with the first ones and that it it last only one day with a previous dose where it was a little sore), PERIPHERAL SWELLING (Then, my left arm started to get red, swollen, and itchy, mostly in the left arm), HAEMORRHAGE (Patient explained that by scratching it, the skin became fragile and started bleeding in some areas), MUSCULOSKELETAL STIFFNESS (The surface of the left arm is stiff and fragile and starting to flake off), PSORIASIS (He also researched and saw a picture of eczema, and recalls that his doctor had told him that he had Psoriasis in his scalp and thought it was that but it didn't match it), ERYTHEMA (Then, my left arm started to get red, swollen, and itchy, mostly in the left arm), SKIN FRAGILITY (The surface of the left arm is stiff and fragile and starting to flake off), SKIN EXFOLIATION (The surface of the left arm is stiff and fragile and starting to flake off) and PRURITUS (Then, my left arm started to get red, swollen, and itchy, mostly in the left arm) had not resolved.        For mRNA-1273.815 (SPIKEVAX 2023-2024) (Unknown), the reporter did not provide any causality assessments.   No Concomitant medications provided by the reporter. Other Moderna covid-19 vaccination details were as follows: patient received first dose on 21-Jan-2021 with batch number 0302275A (not legible), second dose on 22-Feb-2021 with batch number 006M20A, third dose on 18-Nov-2021 with batch number KGF12A (not legible), fourth dose as bivalent on 28-Sep-2022 with batch number AS7163B. Patient left arm started to get red, swollen, and itchy, mostly in the left arm. Patient stated that this whole thing started about 1/2 to 1 inch below where he got the vaccine. Patient received treatment medication as antihistamines with moisturizing cream. But patient stopped   using it after 3-4 days for this treatment medication. Patient stated that the heat and water treatment was working for him, and which caused patient to stopped scratching it is allowing it to heal.  Patent stated that he went back to basics and begin putting washcloth on it and hot water on top of it for about 5-10 minutes, which seemed to stop it from getting worse. This calmed it a bit, and for the next couple of days, he would go to sleep at night, but the morning, it would be hot again and come up. It spread to patient right arm, below the elbow down to his wrist and not as intense as the left which was more intense. In the left arm of patient, it went about 4.5 inches above elbow, in the upper part of the arm. It went from middle part of his lower hand's and spread down the back of hands then it eventually spread down the back of hands started swelling up his arm to about 4.5 inches above his elbow. The patient stated that it was more severe in the dorsal part of the arm and eventually to the dorsal part as well.   This case was linked to US-MODERNATX, INC.-MOD-2023-754428.; Sender's Comments:  US-MODERNATX, INC.-MOD-2023-754428:Bivalent dose