Age: 20.0
Sex: F
Vaccine: COVID19, DT, HEP, OPV, YF
Symptoms: Electrocardiogram ambulatory, Fatigue, Heart rate increased, Heart rate irregular, Tachycardia
Clinical narrative: benign PVCs; felt funny; heart pounding on/off for a good number of days after the episode; Ideopathic peripheral nueropathy; Initial information received in courtesy from Pfizer on 24-Feb-2021 regarding an unsolicited valid non-serious case from other health professional.  This case involves a 20 years old female patient (62.5 cm and 112 kg) who experienced idiopathic peripheral neuropathy (neuropathy peripheral), benign PVCs (Premature ventricular contractions) (ventricular extrasystoles), felt funny (feeling abnormal) and heart pounding on/off for a good number of days after the episode (palpitations), after receiving DIPHTHERIA AND TETANUS TOXOIDS, HEPATITIS B IMMUNE GLOBULIN, YELLOW FEVER VACCINE and ORAL POLIO VACCINE.  The patient's medical history included seasonal, animal and food allergies; adverse reactions to multiple medicines-some severe.  Past medical treatment(s), vaccination(s), family history and concomitant medication(s) were not provided.  On an unknown date in Aug-1988, the patient received a dose of suspect DIPHTHERIA AND TETANUS TOXOIDS (produced by unknown manufacturer), HEPATITIS B IMMUNE GLOBULIN, YELLOW FEVER VACCINE and ORAL POLIO VACCINE not produced by Sanofi Pasteur (lot number and expiration date not reported) via unknown route in unknown administration site for prophylactic vaccination ahead of travel.  Because patient had so many at once, was asked to remain for a little while ; within a very short time, patient told the clinician that she felt funny (feeling abnormal, non-serious, same day latency) and heart pounding on/off for a good number of days after the episode (palpitations, non-serious, unknown latency) following the administration of DIPHTHERIA AND TETANUS TOXOIDS, ORAL POLIO VACCINE, YELLOW FEVER VACCINE and HEPATITIS B IMMUNE GLOBULIN.  Patient reported that clinician checked her and said didn't like what she was seeing and administered EPINEPHRINE (all of this was recorded on her yellow card) and have not had any vaccines then. Patient rather assumed the lasting effect was from the epi-pen, but now, not so certain.  On an unknown date in Jul-2014, the patient developed a serious idiopathic peripheral nueropathy (neuropathy peripheral) (unknown latency) following the administration of DIPHTHERIA AND TETANUS TOXOIDS, ORAL POLIO VACCINE, YELLOW FEVER VACCINE and HEPATITIS B IMMUNE GLOBULIN. This event was assessed as medically significant. it was reported that it came on suddenly, progressed quicky over a matter of weeks, then leveled off and subsided over the years , no cause was identified, though doctors felt likely result of a virus (unspecified).  On an unknown date , (roughly 7-8 years ago from the administration of COVID-coronavirus vaccine) the patient developed a non-serious benign PVCs (Premature ventricular contractions) (ventricular extrasystoles) (unknown latency) following the administration of DIPHTHERIA AND TETANUS TOXOIDS, ORAL POLIO VACCINE, YELLOW FEVER VACCINE and HEPATITIS B IMMUNE GLOBULIN. (Also reported 5-6 years ago- likely result of hormonal changes and eventually subsided and patient had not felt them in years).  No laboratory data was reported.  No clear family history relevant to the adverse events that patient experience, other than many relatives with multiple and sever allergies.  The patient recovered from the events neuropathy peripheral and ventricular extrasystoles, while was unknown for the other two events.  Information on the batch number to be requested.  Additionally reported, at the age of 53 the patient received COVID-19 (coronavirus disease 2019, BNT162B2, first dose, ENS318, difficult to read handwriting, so if lot males non sense, try EN5318) vaccine (Pfizer) on 26-Jan-2021. Also, roughly after 7 minutes after receiving the COVID-19 vaccine, she experienced a dramatic jump in pulse rate (tachycardia -pulse rate 152). She requested assistance and the doctor and nurses at the vaccination site took her to an area, where they found her blood pressure had also jumped (blood pressure spiked to 159/98 and 169/92) and she was having irregular beats (irregular rhythm). They asked if her breathing was ok and if her throat felt ok. Her mouth was dry, and she felt a tightness in her chest, but otherwise no rashes or other clear sign of anaphylaxis. They monitored her for roughly 1.5 hours, requesting help from the EMT (Emergency medical technician) stationed there, who did a brief EKG (Electrocardiography), which showed tachycardia but did not picked up the irregular beats. Upon hearing they had heard and seen irregular beats on the blood pressure monitor, she explained that she had a history of benign PVCs (Premature ventricular contractions), but not experienced them in years and was not medicated for them. Eventually the doctor let her go when the blood pressure came down to 138/89 with a resting pulse rate of 112-114 (still significantly higher than normal). He advised her to follow up with her doctor right away, preferably that same day. Her blood pressure and pulse rate eventually returned to her normal levels 11 hours after the administration of the vaccine. As the tachycardia subsided, she could feel frequent irregular beats. The next day she continued to experience the irregular beats on/off all day long and also experienced a crushing fatigue t7o the point where she needed to take day off from work, something she rarely do. The fatigue subsided by the end of the week, but the irregular heartbeats continued for roughly 10 days before they subsided to the point of not being as noticeable. Patient was on cyanocobalamin (B-12) tablet .That evening and over a next few days, she followed up with her primary care physician, her allergies and ultimately the cardiologist, who ordered a 2 week holter monitor results were still pending. Weighing the risk of COVID, the benefits of the vaccine, history of patient's allergies and reaction to her first dose (particularly the irregular beats which h continued past the initial day of the vaccine). Her allergist and cardiologist suggested to hold on the second vaccine until they can better assess her status and why reaction occurred. A follow up with another allergist who specialized in the vaccine reactions also suggested that she have a cardiac stress test prior to considering a second dose.; Sender's Comments: This case involves a 20 years old female patient who presented with peripheral neuropathy, ventricular extrasystoles, feeling abnormal and palpitations, after vaccinations with DIPHTHERIA AND TETANUS TOXOIDS, HEPATITIS B IMMUNE GLOBULIN, YELLOW FEVER VACCINE and ORAL POLIO VACCINE. Time to onset was compatible with the events feeling abnormal and palpitations, while it was too long to consider for the other two events. The patient's medical history included seasonal, animal and food allergies; adverse reactions to multiple medicines-some severe. However, other relevant patient's medical condition at the time of vaccination, immune status, history of similar episodes with previous vaccinations and lab tests were not reported. Based upon the reported information, the role of an individual vaccine cannot be assessed.