Sex: F
Vaccine: PPV
Symptoms: Insomnia, Malaise, Peripheral swelling, Pruritus, Tenderness
Clinical narrative: the right arm is a little itchy and she is icing it now; feeling knocked out and tired; felt jittery; having an allergic reaction/three huge hives; the right arm was getting swollen; feeling lousy all over; right arm got tender, the pain was to the point that if the sheet brushed the area it was excruciating; the "TYLENOL was not working".; she did not sleep; arm is redish; This spontaneous report has been received from a 65 years old female patient, referring to herself. The patient's pertinent medical history included irritable bowel syndrome (IBS) and thyroid nodules. The patient was allergic to shrimp, lobster, crab and crayfish. The patient's concomitant therapies included loratadine, generic bupropion hydrochloride (WELLBUTRIN), pantoprazole, duloxetine hydrochloride, almotriptan malate (AXERT) and valacyclovir hydrochloride (VALTREX).   On 21-MAY-2020 (Thursday), the patient was vaccinated with pneumococcal vaccine, polyvalent (23-valent) (PNEUMOVAX23) (lot # S036811 with 02-AUG-2021; formulation vial, route, strength and dose were unknown) shot in her right arm (for the first time) for prophylaxis and a zoster rge vaccine (mammalian) (SHINGRIX) shot in her left arm.   On 22-MAY-2020 (Friday), the patient's right arm got tender and on the night the pain was to the point that if the sheet brushed the area it (the pain) was excruciating and the patient did not sleep (insomnia). On the same day (Friday night), the patient took acetaminophen (TYLENOL) (dose, strength, route, frequency, indication, lot number and expiration date were unknown). The patient stated the acetaminophen (TYLENOL) was not working (drug ineffective). On 23-MAY-2020 (Saturday morning), the patient took meloxicam. On the same day, the patient called the physician as she was feeling lousy all over and later in the day the right arm was getting swollen (peripheral swelling) and she took sulfamethoxazole (+) trimethoprim on the night. On 24-MAY-2020 (Sunday), the patient stated that she looked in the mirror and there were three huge hives. The patient stated she called the physician who told her to take diphenhydramine hydrochloride (BENADRYL) as the physician felt the patient was having an allergic reaction. On the same day, the patient took diphenhydramine hydrochloride (BENADRYL) and felt jittery afterwards. On 25-MAY-2020 (Monday) and 26-MAY-2020 (Tuesday), the patient took diphenhydramine hydrochloride (BENADRYL).  On 26-MAY-2020, the patient saw her physician. On 27-MAY-2020, the patient's arm was not as red as yesterday and the swelling had gone down. On the same day, the patient stated she was feeling knocked out and tired, the right arm was a little itchy. On an unknown date in May 2020, the patient received unspecified blood work which results were not provided. The outcome of drug ineffective and insomnia was unknown. The outcome of peripheral swelling was reported as recovering. The outcome of the other events was reported as not recovered. The causality assessment between pneumococcal vaccine, polyvalent (23-valent) (PNEUMOVAX23) and the events was unknown.