Age: 76.0
Sex: F
Vaccine: VARZOS, FLU3, VARZOS
Symptoms: Chest X-ray normal, Musculoskeletal chest pain
Clinical narrative: Information has been received from a 77 year old female consumer reporting on herself with drug allergy to antibiotics, TEGRETOL, DILANTIN and a back surgery who in September 2010, was vaccinated with a dose of ZOSTAVAX (Merck) 0.65 mL subcutaneously (lot number not reported). Concomitant therapy included allopurinol, carvedilol, CEREFOLIN NAC, clonazepam, CRESTOR, hydrochlorothiazide, LOVAZA, LYRICA, NEXIUM, sucralfate, SYNTHROID, zaleplon, morphine, DILAUDID, bupivacaine HCl, clonidine, methadone HCl and acetaminophen/oxycodone hydrochloride. "About 7 days later" in September 2010, the consumer began to experience "excruciating pain from the left breast back to the spine". The consumer had followed up with her doctor and he had prescribed lidocaine 5% ointment to treat the pain. The consumer said she previously reported this adverse event to her pharmacy and had not heard anything back. The consumer would be continuing to follow up with her doctor. No laboratories were performed. At the time of the report the patient had not recovered. Follow-up information has been received from medical records and the patient regarding a 77 year old female ex-smoker with allergies to bacitracin, neomycin, and NEOSPORIN, ampicillin and erythromycin. Concurrent conditions included chronic pain. Medical history included rhizotomy at L5-S1 (May 1980). She had a family history of hypertension. On 15-SEP-2010, the patient received her fourth influenza vaccine (manufacturer, lot number, expiration date and route unknown) in her left arm. On 19-SEP-2010, the patient was vaccinated with a dose of ZOSTAVAX (Merck) subcutaneously (lot number, expiration date and site unknown). Her vital signs while she was seated were: blood pressure: 90/60, pulse: 80 and regular, respirations: 60 and temperature: 97.9 oral. On 23-SEP-2010, the patient experienced extreme pain in her left chest, under her breast which radiated to near her spinal column. Her doctor prescribed lidocaine 5% ointment and ZONALON. On 09-FEB-2011, the patient was seen by her physician with chest tightness cough and some difficulty removing secretions. The physician noted the patient had shortness of breath both at rest and with activity, wheezing and orthopnea. Review of systems also revealed gastroesophageal reflux disease (onset date not specified). A chest x-ray showed haziness in right base which was unchanged from previous x-ray (date not reported). Chronic changes were present with no acute infiltrates. No fractures were seen. The patient reported that she was told by her physician that there was "no fracture or anything that should be causing the pain" and that her physicians were only treating the pain issues, which continued, with the prescribed and compounded ointments. Oxygen saturation by pulse oximeter was 94. It was noted the patient had recurrent problems with her lungs. The physician reported the patient had been hospitalization in November 2010 with right-sided   [Due to memory limitations, the remainder of this text could not be compared.]  ded pneumonia. She had an abnormal brain natriuretic peptide (BNP) and was felt to have had a small vascular ischemia but a non-acute myocardial infarction (it was also noted her cardiac problem "was not well defined"). Listed under chronic problems/past medical history were bronchiectas without acute exacerbation, hemoptysis, abnormal findings-lung field and pneumonia. Under immunization history it was noted that on 15-DEC-2009, she had received a H1N1 influenza vaccine 0.5 cc, intramuscularly (manufacturer, lot number, expiration date and site unknown). The physician's assessment was bronchiectasis without exacerbation and pneumonia resolved. He did not see any acute pneumonia on her current x-ray. The chronic changes on the right side persisted. The plan included continuing increased aerosol frequency of albuterol three times a day by nebulizer, fluticasone and ADVAIR for two weeks, DEP-MEDROL and doxycycline. All available medical records will be provided upon request. Additional information has been requested.