Sex: F
Vaccine: JEVX, RAB, TTOX, TYP
Symptoms: Malaise, Mental impairment, Toxicity to various agents
Clinical narrative: The patient had an adverse reaction to one of the vaccines and was told that was poisoned; Started losing comprehension and realized something was going on in the patient's head; The patient has gotten really sick with vaccinations; The patient had an adverse reaction to one of the vaccines and was told that was poisoned; The patient was vaccinated with two vaccines in one arm, and two vaccines in the other arm on the same day; Case reference number US-BN-2024-002416 is a spontaneous case initially received from a healthcare professional via Communications (reference number: USBAV24-2174) on 29-Aug-2024, and concerns a *78-year-old* female patient.   The patient's medical history and concomitant medication details were not provided.  *On 12-Aug-2024*, the patient was vaccinated with a dose of RabAvert (batch number: unknown), at an unknown dose, *intramuscularly*, for pre-exposure to travel. *On the same day, the patient was vaccinated with co-suspect Japanese encephalitis vaccine (brand name unknown; batch number: unknown), tetanus vaccine (brand name: unknown, batch number: unknown), and typhoid vaccine (brand name: unknown, batch number unknown), all at an unknown dose, administered intramuscularly, for pre-exposure. As reported, the patient got two vaccines in one arm, and two in the other arm (explicitly coded as 'lack of vaccination site rotation'). As reported, on the same day the patient did not feel bad, and it had gotten worse.*  On an unspecified date, *reported as a week and a half later, the patient was hospitalized due to gotten sick with vaccination, feeling out of mind, loosing comprehension and realizing something was going on in the patient's head, stated as severe* and an adverse reaction to one of the vaccines and was told that was poisoned. *As reported, unspecified laboratory analysis was performed (results unknown), and the patient received unspecified treatment for the events.*  *On unspecified date, the patient was discharged from the hospital. Duration of hospital stay was reported as four days.*  *At the time of this follow-up report, the patient did not recover from the events of 'adverse reaction', 'poisoning by rabies vaccine', 'sickness' and 'fuzzy head'.*  *The reporter assessed the events of 'adverse reaction', 'poisoning by rabies vaccine', 'sickness' and 'fuzzy head' as serious due to criteria of hospitalization and possibly related to RabAvert.*  All follow-up information is blended into the case narrative above, with the latest information presented between asterisks (*).  Follow-up information received from a consumer via Communications (reference number: USBAV24-2273) on 06-Sep-2024: New information included: the age of the patient, date of vaccination, co-suspect vaccination details due to which lack of vaccination was coded, additional events of 'sickness' and 'fuzzy head', with updated seriousness and causality assessment and outcome of the events.; Reporter's Comments: A 78-year-old female patient was vaccinated with a dose of RabAvert for pre-exposure to travel, along with co-suspect vaccines, Japanese encephalitis vaccine, tetanus vaccine and typhoid vaccine. As reported, the patient got two vaccines in one arm, and two in the other arm, which is considered as lack of vaccination site rotation. Reportedly, on an unspecified date, reported as a week and a half later, the patient was hospitalized due to gotten sick with vaccination, feeling out of mind, loosing comprehension and realizing something was going on in the patient's head, stated as severe and an adverse reaction to one of the vaccines and was told that was poisoned. Adverse reaction, feeling abnormal and illness are considered as listed per company convention as non-specific events, whilst toxicity to various agents is unlisted and unexpected for RabAvert per CCDS v4 and USPI. Lack of vaccination site rotation is considered as listed per company convention. The patient's medical history and concomitant medication details were not provided. The patient did not recover from the events. The patient's co-suspect vaccinations confounded the causality for the events. Nevertheless, considering implied temporal relationship and since the contributory role of the suspect vaccine cannot be excluded, the reported events have been considered as related to RabAvert. This case is considered as serious due to hospitalization.; Sender's Comments: A 78-year-old female patient was vaccinated with a dose of RabAvert for pre-exposure to travel, along with co-suspect vaccines, Japanese encephalitis vaccine, tetanus vaccine and typhoid vaccine. As reported, the patient got two vaccines in one arm, and two in the other arm, which is considered as lack of vaccination site rotation. Reportedly, on an unspecified date, reported as a week and a half later, the patient was hospitalized due to gotten sick with vaccination, feeling out of mind, loosing comprehension and realizing something was going on in the patient's head, stated as severe and an adverse reaction to one of the vaccines and was told that was poisoned. Adverse reaction, feeling abnormal and illness are considered as listed per company convention as non-specific events, whilst toxicity to various agents is unlisted and unexpected for RabAvert per CCDS v4 and USPI. Lack of vaccination site rotation is considered as listed per company convention. The patient's medical history and concomitant medication details were not provided. The patient did not recover from the events. The patient's co-suspect vaccinations confounded the causality for the events. Nevertheless, considering implied temporal relationship and since the contributory role of the suspect vaccine cannot be excluded, the reported events have been considered as related to RabAvert. This case is considered as serious due to hospitalization.