Age: 75.0
Sex: F
Vaccine: FLUA3, PNC13
Symptoms: Pain in extremity, Peripheral swelling, Pruritus, Skin warm
Clinical narrative: This is a spontaneous report from a contactable nurse (reporting for herself), via Medical Information Team. A 75-year-old female patient received the first dose of PREVNAR 13, intramuscular in left arm on 21Oct2017 15: 00 at 0.5 ml, single for immunization. The vaccine was administered in a Pharmacy/Drug Store. History of all previous immunization with the pneumococcal 13-valent conjugated vaccine (diphtheria crm197 protein) was none. She was told it was a 1 time thing. Medical history included, allergy to thimerosal about 13 years ago and ongoing; her allergy is actually broader than just Thimerosal. She is not sure if it is the Thi- or Thio- mercury derivatives. She was not the only one in the family that had problems with Thimerosal. She used to have Bausch & Lomb eye wash and it used to have something in it that would make her eyes all goopy, but it wasn't Thimerosal. The patient started wearing contacts in 1970. She was also allergic to sulfa medications from late 1980s and ongoing, specifically BACTRIM. The patient also had allergy to wasp stings which developed very slow over probably 10 years and ongoing. The first time she was stung it was just a little swelling like a bee sting. The last time was in 1993 or 1994 and she had an anaphylactic reaction. Concomitant medication included preservative free flu shot; FLUAD (NDC: 70461-0002-01), intramuscular in her right arm on 21Oct2017 at 0.5mL, her right arm was sore for 2-3 days, but never got red or anything like that. Concomitant medications also included ongoing chondroitin sulfate/glucosamine sulfate (GLUCOSAMINE CHONDROITIN 400/500mg, Lot number: 11298900, Expiration date: Mar2020) probably takes 3 times per week and was supposed to take 2 per day (this one was easy to read), ongoing colecalciferol (VITAMIN D3, Lot number: 120981 and Expiration date: Dec2018) at 1000IU probably three times per week (takes about as frequently as the multivitamin), ibuprofen (ADVIL) once in a blue moon, maybe once every 2-3 weeks, and ongoing multivitamin (Lot number: 10347204 and Expiration date: Oct2019) takes probably 3 times per week, takes on and off and was supposed to take once per day. When looking at her Multivitamin and Vitamin D3, stated that if they print the stuff any smaller she would have to get out a giant size magnifying glass, but read all product information without trouble. The patient had an allergic reaction to Prevnar 13 and she was trying to determine what ingredient caused her allergic reaction. It was the same type of reaction she would get with exposure to thimerosal. She developed intense itching, swelling, hardness and heat in her left arm after PREVNAR 13.  One can feel the heat through her sleeve.  She noted that she has received diphtheria shots with no problems in the past. She got the Prevnar 13 a week ago last Saturday on 21Oct2017, and Sunday night 22Oct2017, her arm started to get red, just where the vaccine was administered and started to get hard and sore, which she kind of expected it and really didn't pay much attention to it, because the itching started in the evening of 23Oct2017 and was so intense. By 23Oct2017, it was definitely harder and getting bigger, by the afternoon of the same day, it was probably 3 inches across. The hardness and redness kept increasing and by Tuesday (23Oct2017) it was like 8 inches around her arm and 3 inches between her should and elbow (8 inches long and 3 inches wide). The hardest thing about it was the itching; it itched beyond any mosquito bite or you name it. It itched so badly. That wasn't one of the things she expected. She was allergic to Thimerosal preservative and it was pretty much the same thing, but she got a list of the ingredients and Thimerosal was not on it. On 01Nov2017, hardness, and redness were officially gone. These were in her left arm, where she received the injection. When she noticed the itching in the evening of 23Oct2017, the patient tried to look up what the adverse effect were, etc. She expected soreness at the site, expected warmth and a little redness, but she did not expect intense itching and the fact that it spread on unspecified date. The pharmacist told her that everything she said she had was totally normal. She called a different pharmacy and that pharmacist suggested she take BENADRYL, so she took a little the night before last. The outcome of the event Intense itching, itching that spread, hardness, redness was recovered on 01Nov2017, sore was recovered on an unspecified date. The outcome of other reported events was unknown.