Age: 59.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Blood test, Magnetic resonance imaging, Nerve block, Pain in extremity, Swelling
Clinical narrative: MIGRAINE HEADACHE; RIGHT HAND TURN PALE; TINGLING IN RIGHT ARM AND HAND; COLDNESS IN RIGHT HAND AND TEMPERATURE DIFFERENCE; PAIN IN NECK; LEFT SHOULDER HAD SOME STRAINING IN THE BICEP AREA; PAIN AT ONE POINT BEING 15/10/ VERY SEVERE PAIN; WEAKNESS IN RIGHT ARM/ARM IS VERY WEAK/CANNOT PICK UP ANYTHING; SWELLING IN RIGHT ARM; RED IN RIGHT ARM; PAIN IN RIGHT HAND/SHARP RADIATING PAIN DOWN RIGHT ARM/ INCREASING PAIN IN RIGHT ARM/PAIN STARTED IN THE RIGHT SHOULDER THEN AFFECTED ARM/HAND IS PAINFUL; FLARE UP OF INJURY TO RIGHT SHOULDER/SMALL TEAR IN RIGHT SHOULDER/BLOOD CIRCULATION SUBSIDED TO THE SHOULDER AREA; NERVE DAMAGE; FROZEN RIGHT SHOULDER/COULD NOT DRIVE/MOVE ARM WELL; DIFFICULTY SLEEPING; This spontaneous report received from a patient concerned a 59 year old Asian, Not Hispanic/Latino female. The patient's height, and weight were not reported. The patient's past medical history included fall four months before vaccination, and concurrent conditions included hypothyroidism, and tear in right shoulder. The patient had no history of reaction with previous vaccinations. The patient was previously treated with influenza vaccine for prophylactic vaccination, and measles vaccine for prophylactic vaccination; and experienced drug allergy when treated with diphenhydramine hydrochloride(Benadryl).  The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 041A21A, and expiry: 05-AUG-2021) dose was not reported, 1 total administered on 11-APR-2021, around 13:30 to left arm for prophylactic vaccination. Concomitant medications included lorazepam for shoulder issue, oxycodone for shoulder issue, herbal patches and creams for shoulder issue and paracetamol for shoulder issue.  On 11-APR-2021 after vaccination, the patient started experiencing pain the right arm. The patient took paracetamol (Tylenol) and went to bed but woke up with a sharp radiating pain down the arm and it became red and swollen, and she felt difficulty in sleeping. The patient was taken to emergency room (ER), underwent MRI(Magnetic Resonance Imaging) and found a small tear in right shoulder. The patient took ibuprofen (Advil) and the pain subsided but came back worsened. The patient took paracetamol (Tylenol) for a week for pain but did not helped. On an unspecified date in APR-2021, the patient went to GP (general physician) and got advised to visit orthopedic surgeon who stated that the patient had frozen shoulder and administered some steroids, but did not work for the patient. On an unspecific date in APR-2021, the patient consulted with a neurologist and confirmed she had nerve damage and neurologist advised patient to go to disability support. The patient was on nerve block and pain was gradually getting better but the patient could not move or drive. The patient also could not lie down in any position because of the nerve block. The patient's hand was very painful and consulted with vascular doctors and they stated that some blood circulation has subsided to the shoulder area. The patient went for physical therapy, pool therapy, and acupuncture to help restore shoulder mobility and the patient was getting better. The patient experienced pain, which was started in the right shoulder and then affected the arm also stated she had some migraine headache. The patient stated that the vaccine had caused a flare up of the injury she had on their right shoulder after the fall four months before vaccination. From a pain clinic, the patient confirmed she had nerve damage and it started in April, and continued until May and June also present at the time of reporting although to a lesser degree compared to when it first began. The patient also experienced arm weakness and could not pick anything and pain in neck. In around May or June, the patient started to experience tingling in the arm and hand.  Her left shoulder had some straining in the bicep area at the time of this report. The patient was advised to perform spinal tap by neurology but the patient declined. The patient stated her right hand would get cold and turn pale but not at the tip of the fingers at the time of reporting. Patient took Prednisone 40mg for 7 days for the swelling in their right shoulder but it did not relieve the pain. Patient reported the pain at one point was being 15/10 and it was very severe pain which did not allow her to perform activities of daily living. The patient was usually very sensitive to many medications so the patient taken half dose of medications. Laboratory data (dates unspecified) included: MRI (NR: not provided) Tear in right shoulder, and Pain scale (NR: not provided) 15/10. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from frozen right shoulder/could not drive/move arm well, had not recovered from nerve damage, flare up of injury to right shoulder/small tear in right shoulder/blood circulation subsided to the shoulder area, right hand turn pale, pain in right hand/sharp radiating pain down right arm/ increasing pain in right arm/pain started in the right shoulder then affected arm/hand is painful, and weakness in right arm/arm is very weak/cannot pick up anything, and the outcome of migraine headache, tingling in right arm and hand, swelling in right arm, red in right arm, coldness in right hand and temperature difference, pain in neck, difficulty sleeping, left shoulder had some straining in the bicep area and pain at one point being 15/10/ very severe pain was not reported. This report was serious (Other Medically Important Condition).; Sender's Comments: V0:20210730941-covid-19 vaccine ad26.cov2.s-Pain in right hand/sharp radiating pain down right arm/ increasing pain in right arm/pain started in the right shoulder then affected arm/hand is painful. This event(s) is labeled per RSI and is therefore considered potentially related.