Age: 50.0
Sex: F
Vaccine: FLU3, PPV, FLU3, PPV
Symptoms: Epistaxis, Fatigue, Headache, Heart rate increased, Joint stiffness
Clinical narrative: From initial information received on 02/25/04 from a county health service regarding an adverse event occurring in the USA, it was reported that a 49 year old female patient received a Fluzone SV '2003-'2004 USP vaccination, lot number U194AA, administered intramuscularly in the left deltoid, and a Pneumovax 23 vaccination, lot number 0029N, administered intramuscularly in the right deltoid on 11/10/03 at 5:00 PM. Thirty minutes later the patient noted dizziness at home. At 8:00 PM, the patient went to bed with soreness of both arms with the left on being worse that the right. She experienced absolute fatigue, headache and sinus feeling pressure. She took Tylenol, Ibuprofen and another medication for relief. The patient " had a rough night up six times to get relief of pain, aches in knees in the night". On 11/12/03, the symptoms "kind of lifted". Her left arm was still sore, shoulder joint to knuckles stiff and could not be used, muscles felt sore and injection site was hot. Her right arm had minimal soreness. She felt miserable and had no appetite. Her sinus headache went to a migraine in the afternoon. She took a long nap, couldn't quite put her knees together and she ached. In the afternoon, she felt chilled. At 6:00 Pm she began shivering under three quilts, vomited and diarrhea started. She was taking a lot of Ibuprofen. On 11/13/03, the headache resolved, but she couldn't bend her elbow. She slept in the afternoon and felt better so she went to work. As she was driving she became hot and could no longer drive. She felt like " I had run a marathon". She went to the doctor for another reason and the doctor noted a fast heart rate. On 11/14/03, her arm began to bend. Her stomach was upset and she didn't want to eat. She began to have a sinus headache, more diarrhea and noted dark stools. She experienced a nosebleed and dizziness at intervals. It was at this time the patient called the county health service and was encouraged to seek medical attention and to report the above events at which time she refused. On 11/15/03, the patient did not eat breakfast, did not have an appetite and had a nervous stomach. She denied any headache and migraine and can now move her fingers. Her knee aches and elbow aches have subsided. On 11/20/03, her shoulder to elbow was stiff. On 11/30/03, she experienced stiffness and aches. The patient has stated "I have had 4 bouts of flu like symptoms about every 10 days following my shot". The patient did not seek medical evaluation from her medical provider because she has had reactions in the past and reportedly physician thinks she is somewhat of a hypochondriac. The patient has completely recovered from these events. From additional information received on 09/13/04 from the initial reporter, the patient was not on any other medications at the time of vaccination. The patient refused to go to a medical provider. The reporter stated that the case was reviewed and that there is no additional information at this time. No further information is anticipated, this cause is considered closed.