Age: 54.0
Sex: F
Vaccine: COVID19
Symptoms: Swelling, Vaccination site pain
Clinical narrative: nerve pain that was going down the length of her left arm was reported as worsened; felt this one and it didn't feel right. It hurt immediately and she could feel the medicine going in, it felt icky, like it hurt; received the booster dose; nerve pain in her left arm, down the whole arm; pain at the injection site that comes and goes; feeling ill kind of like the flu; redness; swelling; itchiness; soreness in her arm; she was just not feeling well; having like a phantom injection or it feels like someone every now and then is punching her in the arm where the injection was/ phantom pain; This is a spontaneous report received from contactable reporter(s) (Consumer or other non HCP) from medical information team. The reporter is the patient.  A 54 year-old female patient received bnt162b2 (BNT162B2), administered in arm left, administration date 21Sep2021 (Lot number: 301308A) at the age of 54 years as dose 3 (booster), single for covid-19 immunisation. The patient's relevant medical history was not reported. Concomitant medication(s) included: PRALUENT. Past drug history included: Praluent, start date: 18Sep2021, notes: she took her 1st one on 18Sep2021; Praluent, start date: 02Oct2021, reaction(s): "she didn't have any reaction to that other than her bruising herself", notes: she took her second Praluent injection on 02Oct2021; Imuran, notes: 2 years ago she stopped taking Imuran which is an immunosuppressant drug. The following information was reported: IMMUNISATION (non-serious) with onset 21Sep2021, outcome "unknown", described as "received the booster dose"; NEURALGIA (non-serious) with onset Sep2021, outcome "unknown", described as "nerve pain in her left arm, down the whole arm"; VACCINATION SITE PAIN (non-serious) with onset Sep2021, outcome "unknown", described as "pain at the injection site that comes and goes"; ILLNESS (non-serious) with onset Sep2021, outcome "unknown", described as "feeling ill kind of like the flu"; ERYTHEMA (non-serious) with onset Sep2021, outcome "unknown", described as "redness"; SWELLING (non-serious) with onset Sep2021, outcome "unknown", described as "swelling"; PRURITUS (non-serious) with onset Sep2021, outcome "unknown", described as "itchiness"; PAIN IN EXTREMITY (non-serious) with onset Sep2021, outcome "unknown", described as "soreness in her arm"; MALAISE (non-serious) with onset Sep2021, outcome "unknown", described as "she was just not feeling well"; PHANTOM LIMB SYNDROME (non-serious) with onset Sep2021, outcome "unknown", described as "having like a phantom injection or it feels like someone every now and then is punching her in the arm where the injection was/ phantom pain"; CONDITION AGGRAVATED (non-serious), outcome "unknown", described as "nerve pain that was going down the length of her left arm was reported as worsened"; PAIN (non-serious) with onset 21Sep2021, outcome "unknown", described as "felt this one and it didn't feel right. It hurt immediately and she could feel the medicine going in, it felt icky, like it hurt". Therapeutic measures were taken as a result of pain in extremity.  Additional information: It was reported that Caller is a consumer. Pfizer covid 19 vaccine, booster dose confirmed. Caller received the booster dose on 21Sep2021. Caller reports "a few days" after, she developed nerve pain in her left arm, down the whole arm. She received her booster dose in her left arm. Caller compared this nerve pain to "tennis elbow or arm". Caller is still experiencing this pain. Caller says she "thinks it has gotten worse". Caller also reports pain at the injection site that comes and goes, describes this pain as "someone is hitting her" and as a "phantom pain".Caller reports speaking to at least 2 out of 3 of her doctors regarding this issue. Caller reports having a telemedicine visit with her rheumatologist on 11OCT where she described her reactions to the shot as "feeling ill kind of like the flu" and feeling "horrible. Caller said this doctor "did not feel the need to do labs" and she is planning on obtaining her lab results from the endocrinologist. Caller has also talked with many pharmacists and has been told "sounds like you hit a nerve" when receiving the vaccine. Caller said "I will say when I did receive it, I felt it go in and felt the injection, feel the medicine going it". Caller said it "feels like "ech"", like an IV fluid going in". Caller says she has a heart condition and recently starting taking a new medication. Caller inquired and said "give me some confidence...can I resume taking Aleve, prn?". Caller said a "pharmacist told me on 01Nov2021 to stop taking Aleve because of risk of blood clot". Provided caller with response from the CONS document attached: "Talk to a doctor about taking over-the-counter medicine, such as ibuprofen,acetaminophen, aspirin (only for people age 18 or older), or antihistamines for any pain and discomfort experienced after getting vaccinated. People can take these medications to relieve side effects after vaccination if they have no other medical reasons that prevent them from taking these medications normally" and "The Comirnaty and Pfizer-BioNTech COVID-19 Vaccine Fact Sheet for Recipients and Caregivers does not discuss the use of fever-reducing drugs or pain relievers before or after vaccination. It is not completely known how medications that reduce fever (antipyretics) and pain (analgesics), like acetaminophen and ibuprofen, may interfere with how well the vaccine works."Caller states that she has a hearing problem. She received the booster dose of her COVID 19 shot on 21Sep2021 and at the time that she received it, compared to her husband's injection and her other injections, she felt this one and it didn't feel right. It hurt immediately and she could feel the medicine going in, it felt icky, like it hurt. She had the normal reaction that other people have had- redness, swelling and itchiness but then within the first week she was having nerve pain that was going down the length of her left arm, which is the arm that she received the vaccine in, it was going down to her forearm and it had affected her elbow, her grip and her fine motor. She called around and inquired if this was normal and she was told that it was and that it is going to hurt for a little while, that's what everyone else has been saying and it is going to be red and itchy. She mentioned to whoever she had contacted that she is having weird nerve pain and to this day she is having the nerve pain. It is affecting her elbow, like tennis elbow, but she has never had this before. Her husband has experienced tennis elbow before when he had lifted something wrong and twisted his forearm muscles. That's the only thing that she can equate it to is tennis elbow or something like that along the nerve that runs down the forearm and it is stemming from the injection site. She is also having like a phantom injection or it feels like someone every now and then is punching her in the arm where the injection was, that has gotten quite a bit better but she still has the nerve pain. She has been taking Aleve and Tylenol and has been alternating them for the first number or weeks or a month and then she was recently told to stop the Aleve by someone at the (Name) and then they had recounted what they said and said that she actually can take the Aleve because she is dependent on Aleve because she has lupus. Inquired when her side effects began and she says that it was a few days after she had the shot. She was having soreness in her arm of course but she was just not feeling well, she had unusual soreness. She used ice for the first three days nonstop and she would take it off every 10 to 15 minutes and she used a heat pad and then she would alternate Tylenol and then take Aleve. That was going on for the first couple weeks and then she began not taking so much Tylenol or Aleve anymore as she was initially. It will wreck her stomach if she takes too much Tylenol. Here and there she would take Tylenol with codeine because the nerve issue was so predominant. Inquired for the nerve pain outcome and caller states that it is still going on and it has gotten a little worse. Its really affecting her at the elbow area and down to the forearm. It has gotten better in the upper quadrant of her arm, the bicep, but it is not as much in the inner bicep as much. She had her shot on the exterior of her forearm (documented as provided by caller) and on the far left area. She even had a coupe of pictures that she took a while back. She still is able to feel the injection site and she had a scab on it for quite a while and she still can feel part of it. It is like the phantom pain that she has over the injection site. She showed it to the pharmacist and she another one as well when they had asked to see where she was injected at. She saw the lead pharmacist this past Sunday, 21Nov2021, when she had gotten the Tylenol with codeine that her rheumatologist prescribed to her because she had let him know that her arm was hurting. It was prescribed partially for her arm and partially for her 23 year old who is healing from an artificial hip. She saw the lead pharmacist on 21Nov2021 and that wasn't the first time that she had spoke with that pharmacist this was just the caller following up with her and saying that she was still having the nerve pain from the injection.History/ Investigations: No, nothing relevant. She has actually been lupus flare free for 2 years if not 2 1/2 years. She had asked during one of her telemedicine visits with her rheumatologist if this might have something to do with polyneuropathy pain or anything else with lupus and the rheumatologist just said that it sounds like she had a bad injection and that it maybe hit a nerve and she said that she didn't realize that she had to be aware or think of an injection hitting a nerve. That was new to her. She spoke with her heart doctor and asked if this could have anything to do with her new heart medication, Praluent injection. She injects it into her thighs, not her arms, and she has only had 4 injections. When she had her booster dose she hadn't even began the drug yet. She then clarifies that she had her booster dose on 21Sep2021 and she took her second Praluent injection on 02Oct2021 and she took her 1st one on 18Sep2021 and she didn't have any reaction to that other than her bruising herself because her held onto the injection button too long in her thigh and that was the only complication with that injection that she gave herself into her left thigh and she let her doctor know about that. It is the 75 mL dose. Then she had her booster shot which by the way she had her 2nd Pfizer injection 5 months prior to her booster and was told, after checking twice with them, that it was okay to have the booster even though it hadn't been 6 months. They said it was okay because she is immunocompromised. Her doctor considered her as that at the time because 2 years ago she stopped taking Imuran which is an immunosuppressant drug that is typically used for organ failure. That's basically what lupus is, but that hasn't been the case for her. She has spoken with her doctor about this and about how well she is doing with lupus and her doctor is doing hoorays on how wonderful she is doing. Her fasting labs are comparable to a 21 year old labs, says her heart doctor and everything is great.  Follow-up attempts are completed. No further information is expected.