Age: 76.0
Sex: F
Vaccine: VARZOS
Symptoms: Palpitations, Sinus arrhythmia, Uterine dilation and curettage
Clinical narrative: palpitations; Fatigue; chills; Malaise; Heat at the injection site; Local discomfort / Injection site; Sinus arrhythmia; Possible right bundle branch block; Thickened endometrium; Dysrhythmia; This case was reported by a nurse via call center representative and described the occurrence of dysrhythmias in a 76-year-old female patient who received Herpes zoster (Shingrix) for prophylaxis.   The patient's past medical history included palpitation (during menopause). Concurrent medical conditions included eyeglasses wearer, endometrial cancer and ovarian adenocarcinoma.   On 10th July 2020, the patient received the 1st dose of Shingrix (intramuscular). On 10th July 2020, less than a day after receiving Shingrix, the patient experienced injection site warmth and injection site discomfort. On 11th July 2020, the patient experienced fatigue, chills and malaise. On 12th July 2020, the patient experienced palpitation. In July 2020, the patient experienced dysrhythmias (serious criteria GSK medically significant), sinus arrhythmia, right bundle branch block and endometrial thickening. In July 2020, the outcome of the injection site warmth, injection site discomfort, fatigue, chills and malaise were recovered/resolved. On 14th October 2020, the outcome of the palpitation was recovered/resolved. On an unknown date, the outcome of the dysrhythmias, sinus arrhythmia, right bundle branch block and endometrial thickening were unknown.   It was unknown if the reporter considered the dysrhythmias, injection site warmth, injection site discomfort, sinus arrhythmia, right bundle branch block, fatigue, malaise, palpitation and endometrial thickening to be related to Shingrix. The reporter considered the chills to be related to Shingrix.  Additional information was provided as follows: The case was reported by patient her self who was a retired nurse. The patient received vaccine intramuscularly in the left deltoid. The patient experienced local discomfort and heat at the injection site which resolved. On Saturday 11th July 2020 the patient experienced chills and fatigue/malaise. On Sunday evening 12th July 2020 the patient began experiencing palpitations. She mentioned that she was not sure if the palpitations were related to the Shingrix or not because she had other stressors (she learned that her husband had cancer). On 28th July 2020 she learned the results of her Dilation and Curettage which was that she had a thickened endometrium which required a hysterectomy. An EKG  (Electrocardiogram) was done which showed dysrhythmia, sinus arrhythmia and possible right bundle branch block. Due to the results of the EKG and because the palpitations had not yet resolved her hysterectomy surgery had to be postponed. She did have the hysterectomy surgeryon 14th October 2020. The palpitations had stopped by 14th October 2020. There were no complications during surgery, there was no dysrhythmia during the surgery. The patient had endometrial cancer and possible adenocarcinoma of the ovary as well. She might require chemotherapy. She had not yet had a follow up EKG but she was scheduled to have one. The reporter consented to follow up.