Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Blood alkaline phosphatase, Blood pressure measurement, Blood test, Electrocardiogram, Fatigue
Clinical narrative: had a mild reaction to the Moderna vaccine- felt "achy" and exhausted with flu-like symptoms but no fever.; had a mild reaction to the Moderna vaccine- felt "achy" and exhausted with flu-like symptoms but no fever.; had a mild reaction to the Moderna vaccine- felt "achy" and exhausted with flu-like symptoms but no fever.; This spontaneous case was reported by a patient and describes the occurrence of PAIN (had a mild reaction to the Moderna vaccine- felt "achy" and exhausted with flu-like symptoms but no fever.), INFLUENZA LIKE ILLNESS (had a mild reaction to the Moderna vaccine- felt "achy" and exhausted with flu-like symptoms but no fever.) and FATIGUE (had a mild reaction to the Moderna vaccine- felt "achy" and exhausted with flu-like symptoms but no fever.) in a 67-year-old female patient who received SPIKEVAX NOS (SPIKEVAX NOS) for COVID-19 prophylaxis.     The patient's past medical history included COVID-19 in 2022. Previously administered products included for Product used for unknown indication: Flu vaccine (She did have a reaction to flu vaccine a year ago and also in 1970, and she was being very careful about which arm she used.) in 1970, Pfizer Covid-19 vaccines (dose 1 : patient had 2 Pfizer Covid-19 vaccines, which were okay), Pfizer Covid-19 vaccines (dose 2 : patient had 2 Pfizer Covid-19 vaccines, which were okay) and Caladryl mixed with Benadryl (Caladryl mixed with Benadryl caused the skin to completely wave off); for Drug use for unknown indication: Diclofenac Sodium (took one pill of Diclofenac Sodium about 2 years ago and she was anaphylactic to it). Past adverse reactions to the above products included Anaphylactic reaction with Diclofenac Sodium; No adverse event with Pfizer Covid-19 vaccines and Pfizer Covid-19 vaccines; Skin peeling with Caladryl mixed with Benadryl; and Vaccination adverse reaction with Flu vaccine. Family history included Heart disorder (four of the patient's grandparents, all had heart conditions and might have inherited the heart condition). Concurrent medical conditions included Hypophosphatasia, Drug allergy (allergic to thimerosal), Allergy to chemicals (sensitive to preservatives, could not tolerate preservative, could not take any saline solution that had preservative in it), Drug allergy (allergic to Benadryl), Allergic skin reaction (got rash and got Poison Ivy, got exposed to Poison Ivy and used calamine lotion on it, she had no problem but when she used Caladryl which was mixed with Benadryl, it caused the skin to completely wave off) and Hypophosphatasia. Concomitant products included ASFOTASE ALFA (STRENSIQ) for Hypophosphatasia.    In 2022, the patient received third dose of SPIKEVAX NOS (SPIKEVAX NOS) (unknown route) 1 dosage form. On an unknown date, the patient experienced PAIN (had a mild reaction to the Moderna vaccine- felt "achy" and exhausted with flu-like symptoms but no fever.), INFLUENZA LIKE ILLNESS (had a mild reaction to the Moderna vaccine- felt "achy" and exhausted with flu-like symptoms but no fever.) and FATIGUE (had a mild reaction to the Moderna vaccine- felt "achy" and exhausted with flu-like symptoms but no fever.). The patient was treated with NAPROXEN SODIUM (ALEVE) for Throbbing pain, at an unspecified dose and frequency. At the time of the report, PAIN (had a mild reaction to the Moderna vaccine- felt "achy" and exhausted with flu-like symptoms but no fever.), INFLUENZA LIKE ILLNESS (had a mild reaction to the Moderna vaccine- felt "achy" and exhausted with flu-like symptoms but no fever.) and FATIGUE (had a mild reaction to the Moderna vaccine- felt "achy" and exhausted with flu-like symptoms but no fever.) outcome was unknown.      DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Blood alkaline phosphatase: always low. On an unknown date, Blood pressure measurement: elevated. On an unknown date, Blood test: she was not having a heart attack, and her blood work looked pretty good. On an unknown date, Electrocardiogram: she was not having a heart attack, and her blood work looked pretty good.         The patient was calling in regards to the Pfizer Covid-19 vaccine. She had taken a total of 6 Covid-19 vaccines with one of them being Moderna vaccine. The patient had some adverse reactions and was not sure if it was because of the recent vaccine. The patient wanted to know if the recent vaccine had flu vaccine in it. The patient wanted to know if any safety information on the side effects experienced particular to the physician's comment on heart lining's inflammation potentially caused by the vaccine. Caller mentioned that she got a series of vaccines last year which were spaced a month apart. The patient was able to figure out that it was the flu vaccine that caused to have an adverse reaction - a softball size lump on arm after getting the flu vaccine. The patient had 2 Pfizer Covid-19 vaccines and then 1 Moderna vaccine. The patient had a mild reaction to the Moderna vaccine : felt achy and was exhausted with flu-like symptoms but had no fever. Because of this, the patient went back to getting the Pfizer Covid-19 vaccines where the patient got 2 more shots. The patient was given the latest Pfizer Covid-19 vaccine on the 9th and started having a reaction on the 10th. The patient described that after getting the vaccine, the patient had a lot of sneezing in the afternoon. In the noon of next day, on the 10th, the patient had a cup of coffee and felt a heart attack like sharp pains, throbbing pains, and felt light-headed. The patient took two antacids because the patient thought that it was just gas pain. So the patient got antacid 2 pieces. The patient thought that it was just gas pain but was not relieved and was not relieved after taking the antacids. The patient was getting worse, so the patient took baby Aspirin, but the pains continued. The patient went to the nearest hospital. They agreed that the patient was having chest pains and the blood pressure elevated.  They also said that they did not think it was a heart attack but it was possible that there was inflammation of the muscle in the heart wall. After taking Aleve, the throbbing pain was gone. The patient described that Aleve helped the patient. The patient was allergic to thimerosal and was very sensitive to preservatives. The patient also mentioned that she got Covid-19 back in 2022. The patient said that the patient was not hospitalized. The patient had another case of Covid in Jul-2023. After hearing the response, the patient mentioned that four of the patient's grandparents, all had heart conditions and might have inherited the heart condition.   The patient also mentioned that the previous Pfizer Covid-19 vaccinations were okay and the patient wanted to know the difference for this recent Pfizer Covid-19 vaccine which the patient had on the 9th to which the patient had a reaction to. The patient had several side effects after getting the most recent Pfizer Covid-19 vaccine and wanted to know what the recommendations would be if the patient needed to get another shot of the Pfizer Covid-19 vaccine.  The patient stated, to have had now 6 total COVID vaccines and the patient was very grateful. The first 2 vaccines were Pfizer, the third one was Moderna and then all the rest had been Pfizer. The patient just recently had the sixth vaccine and that was on 09-Nov-2023 and the patient believed that the patient might have had an adverse reaction to it. The patient said that the patient believed it because either the patient had a reaction to the vaccine or the patient pulled muscle sneezing the night before and that could have been due to allergies. So, the patient could not be 100 percent sure how the patient had the muscle reaction that the patient had but it felt like internally to the patient and the physician concurred because the patient rounded up heading to the hospital because she was having muscle spams around the heart and it was on the left side of the heart and underneath the heart and she could feel it. She thought that she was having a heart attack but she was 67 years old, felt that obviously she was a woman and had severe chest pain and was feeling very light headed and was struggling to walk and so she thought it was not good and she was at shopping, it was about noon the next day so, it was about 24 hours after the injection and so she thought that she need to get a Baby Aspirin that had been protocol from the cardiologist for quite a few years due to chest pain or something like that and she did suffered from a very rare genetic disease, that was just diagnosed a year and a half ago. Once, she had medicine for the bone disease and then she did not have to take the Baby Aspirin anymore and it was very interesting for her. So all of these were difficult for her because she was unique to fully diagnose it, hence she could not 100 percent say that it was due to the Pfizer vaccine.  The patient had taken 5 Pfizer vaccines and 1 Moderna vaccine. When probed to clarify if the patient had experienced the events after taking Pfizer COVID-19 Vaccine, the patient stated, that she drove herself to the emergency room because first, she got an antacid that was usually what it was when she had chest pain of some kind that was usually she was having some backup and reflux and hence took an Antacid that did not had no reaction to the chest pain, she was still having a chest pain. So, then she went and started driving home and was not even home yet the pain was getting worse, it was a throbbing pain and so, she went to another Pharmacy and found Baby Aspirin and took one of those again it did not make a difference to the chest pain and was still having it and they were increasing in frequency so, she drove to the nearest hospital and they did an EKG immediately, they did blood work and so on and they said that she was not having a heart attack, and her blood work looked pretty good. They agreed with her, so, she took 2 doses of Aleve and had to take it again the next day and on the third day, she was fine, so that was considered as the solution to it and they agreed with her that it was possibly a muscle inflammation and so it reacted to the Aleve in exactly that way with the throbbing at ease and the pain became ease. She just took 2 doses of antacid.  She never had a reaction to any other vaccine of any kind, she had many allergies and some of her allergies could be anaphylactic and they were unusual like she was allergic to Benadryl. But they mixed Benadryl into calamine lotion and most of her allergies was skin allergies, she got rash and got Poison Ivy, got exposed to Poison Ivy and used calamine lotion on it, she had no problem but when she used Caladryl which was mixed with Benadryl, it caused the skin to completely wave off.  She could not tolerate preservative, could not take any saline solution that had preservative in it, for example, she had a severe reaction to certain preservative. She did have a reaction to flu vaccine a year ago, and she was being very careful about which arm she used. She was staggering the vaccine, so, she had the pneumonia vaccine, had no reaction to it but she had the flu vaccine at the physician's office and her arm swelled up, had a lump to the size of soft ball on the arm, so she thought she was better not take the flu vaccine again and almost never get the flu. She rarely got the flu even when she was treating her children for flu and they have had severe cases of flu. She did not have the flu and had rarely taken a flu vaccine because the first time she did was in 1970s and she had a reaction to it  The patient had a rare genetic disease called HPP, that was called Hypophosphatasia which meant that the patient was low, and she was always low in the alpha phosphatase enzyme. She takes Strensiq for hypophosphatasia and had no adverse reaction to Strensiq and had been taking it for a year and a half.  The patient had undergone bloodwork and could not get the result but the physician said that the result was good, that she was low in what he would expect if she was having heart attack. She was anaphylactic to Diclofenac Sodium which was said to be in similar family to Aleve or to Naproxen but she had no problem taking Naproxen and Aleve and she took one pill of Diclofenac Sodium about 2 years ago and she was anaphylactic to it. She took Aleve as a treatment for muscle spasms, and that helped. She took 2 doses of Aleve, 12 hours apart and did it 3 times.  The patient received Pfizer vaccine on about 1 pm on 09-Nov-2023 and had the reaction on about the noon of 10-Nov-2023. Anatomical site of vaccine administration was left arm and prior vaccination (Within 4 weeks) was none. It had been about 6 months since the patient took last Pfizer vaccine.