Sex: F
Vaccine: VARZOS
Symptoms: Malaise, Pain in extremity, Sleep disorder
Clinical narrative: tired; had some "spells"; sleep disturbances; frightened; potential allergy reaction; flu like symptoms; headache; Lightheadedness\ feeling of Light headedness; malaise; pain at injection site; painful arm; red from top of arm to elbow; This case was reported by a pharmacist via call center representative and described the occurrence of influenza-like symptoms in a 59-year-old female patient who received Herpes zoster (Shingrix) for prophylaxis.   Concurrent medical conditions included seasonal allergy (grass allergy, pollen allergy) and allergy to plants (trees allergy).   On 14th November 2019, the patient received the 1st dose of Shingrix. On 15th November 2019, 1 days after receiving Shingrix and an unknown time after starting Zyrtec and Imitrex, the patient experienced influenza-like symptoms, headache, light headedness, malaise, injection site pain, pain in arm, erythema of extremities and allergic reaction. On 18th November 2019, the patient experienced tiredness, adverse reaction, sleep disturbance and fear. The patient was treated with cetirizine hydrochloride (Zyrtec), benadryl (nos) (Benadryl) and sumatriptan succinate (Imitrex). On 17th November 2019, the outcome of the erythema of extremities was recovering/resolving. On 20th November 2019, the outcome of the headache was recovered/resolved. On an unknown date, the outcome of the influenza-like symptoms, light headedness, malaise, injection site pain, pain in arm, tiredness, adverse reaction, sleep disturbance, fear and allergic reaction were unknown.   It was unknown if the reporter considered the influenza-like symptoms, headache, light headedness, malaise, injection site pain, pain in arm, erythema of extremities, tiredness, adverse reaction, sleep disturbance, fear and allergic reaction to be related to Shingrix.  Additional details were provided as follows: The age at vaccination was not reported. The patient described she had very bad reactions between 15th November 2019 and 20th November 2019.  On 15th November 2019, the day after vaccination, patient had flu like symptoms, persistent headache, lightheadedness, malaise, pain at injection site and her left deltoid was red from top of arm to elbow and extremely painful to touch. On evening of 16th November 2019, she took a Zyrtec for which she had on hand for seasonal allergies. On 17th November 2019, about half the redness in her arm had gone away.  On 17th November 2019 evening, the patient took a Benadryl. On 18th November 2019, the patient went to work but still had the headache, feeling lightheaded, tired, and had some "spells" so she went to the emergency room (ER). ER doctor she saw wondered if she was having TIA or stroke so she had a CT scan and bloodwork done, and all tests were negative for stroke. The patient had also experienced sleep disturbances for unknown time and was really frightened over the whole process she informed. On 19th November 2019 she went to a neurologist and in evening the patient also took her husband's Imitrex. On Wednesday 20th November 2019, when she woke, the headache was gone On Thursday 21st November 2019, she felt mostly back to normal. The patient read that Shingrix adjuvant had willow bark ingredient, and wondered if it was a potential severe allergy reaction.