Age: 76.0
Sex: F
Vaccine: VARZOS
Symptoms: Eyelid irritation, Fatigue, Feeling abnormal, Headache, Lymph node pain
Clinical narrative: Left-sided neurological pain; surging headaches/pain shooting into top of head; soreness if arm was pressed.; eye is quite closed and not completely back; Stiff; Neck pain; Ear pain; gland on side of face tender; abnormal; Redness/red mark on her forehead and a line going down into scalp; rash extending down nose and near eye and into cheek; Rash red, bumpy, scaly, and rough; bumpy rash; Rash red, bumpy, scaly, and rough; Chills; felt tired/exhausting/ face tenderness; Malaise; Tender scalp; This case was reported by a consumer via call center representative and described the occurrence of chills in a 76-year-old female patient who received Herpes zoster (Shingrix) for prophylaxis.   On 17th December 2019, the patient received the 1st dose of Shingrix. In December 2019, less than 3 weeks after receiving Shingrix and an unknown time after starting Valacyclovir, the patient experienced scalp tenderness. On 18th December 2019, the patient experienced chills, tiredness and malaise. On 22nd December 2019, the patient experienced erythema, rash, red rash, papular rash and rash scaly. On 3rd January 2020, the patient experienced stiffness, neck pain, ear pain, lymph node pain and feeling abnormal. On an unknown date, the patient experienced nerve pain, headache, pain and eyelid discomfort. The patient was treated with gabapentin, valaciclovir hydrochloride (Valacyclovir) and prednisone. On an unknown date, the outcome of the chills, tiredness, malaise and pain were resolved with sequelae and the outcome of the erythema, red rash, rash scaly, scalp tenderness, nerve pain and stiffness were recovering/resolving and the outcome of the rash, papular rash, headache, neck pain, ear pain, lymph node pain, feeling abnormal and eyelid discomfort were unknown.   It was unknown if the reporter considered the chills, tiredness, malaise, erythema, rash, red rash, papular rash, rash scaly, scalp tenderness, nerve pain, headache, pain, stiffness, neck pain, ear pain, lymph node pain, feeling abnormal and eyelid discomfort to be related to Shingrix.  Additional case details were reported as follows: The patient received Shingrix in her left arm and developed chills, felt tired and malaise that lasted a couple of days.  The consumer reports noticing a red mark on her forehead and a line going down into scalp. Caller went to a doctor's appointment and was prescribed valacyclovir. The consumer went to an ophthalmologist appointment due to rash extending down nose and near eye and into cheek. At the ophthalmologist appointment caller was prescribed prednisone for the eye. After probing, caller described rash as red, bumpy, scaly, and rough that was on left side of face and seems to become milder as each day passes. Scalp described as being tender on the left side of head, especially when hair is being pulled.  The consumer reported being prescribed gabapentin for neurological pain which causes tiredness and sleep for 3-4 hours but also stated possible relief due to milder symptoms each day.  The consumer briefly mentioned having surging headaches from scalp to necks and no herpetic pain described as pain shooting into top of head.  The consumer stated no arm discomfort following vaccination other than mild soreness if arm was pressed.  At the time of reporting the patient had notable side effects reported as entire left side specifically stating neck, ear and left gland on side of face all tender and stiff and abnormal and exhausting.  The caller reported eye was quite closed and not completely back.  The reporter consented to follow up. The patient could not find lot number on pharmacy paperwork.