Age: 26.0
Sex: M
Vaccine: COVID19
Symptoms: Dyspnoea, Erythema, Fatigue, Feeling hot, Gastrooesophageal reflux disease
Clinical narrative: tachycardia; hypertensive; swelling of both of my fingers and palms on each hand began; A rash also appeared on both of the palms of my hands.; burning pain / Stabbing pain; Fatigue; Chills; Myalgia; Fever between 100-102 deg F; slight difficulty in breathing; severe acid reflux (never had in my life); malaise; Chest tightness; expiratory wheezing; Cold sweat; Chronic Spontaneous Urticaria; dermatographia; I began to experience full body hives predominantly behind my neck and ears, my torso, and my groin area/wheals; warmth; Erythema; itchiness; Flu-like; This spontaneous case was reported by a consumer and describes the occurrence of CHRONIC SPONTANEOUS URTICARIA (Chronic Spontaneous Urticaria), MECHANICAL URTICARIA (dermatographia), URTICARIA (I began to experience full body hives predominantly behind my neck and ears, my torso, and my groin area/wheals), FEELING HOT (warmth) and PRURITUS (itchiness) in a 26-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 026c21a) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below.     Concomitant products included VITAMINS NOS (DAILY MULTIVITAMIN) and FISH OIL for an unknown indication.   On 07-Sep-2021, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. In September 2021, the patient experienced PRURITUS (itchiness) and INFLUENZA LIKE ILLNESS (Flu-like). On 19-Sep-2021, the patient experienced CHRONIC SPONTANEOUS URTICARIA (Chronic Spontaneous Urticaria), MECHANICAL URTICARIA (dermatographia), URTICARIA (I began to experience full body hives predominantly behind my neck and ears, my torso, and my groin area/wheals), FEELING HOT (warmth) and ERYTHEMA (Erythema). On 20-Sep-2021, the patient experienced MALAISE (malaise), CHEST DISCOMFORT (Chest tightness), WHEEZING (expiratory wheezing), COLD SWEAT (Cold sweat), DYSPNOEA (slight difficulty in breathing), GASTROOESOPHAGEAL REFLUX DISEASE (severe acid reflux (never had in my life)), FATIGUE (Fatigue), CHILLS (Chills), MYALGIA (Myalgia) and PYREXIA (Fever between 100-102 deg F). On 21-Sep-2021, the patient experienced PAIN (burning pain / Stabbing pain), PERIPHERAL SWELLING (swelling of both of my fingers and palms on each hand began) and RASH (A rash also appeared on both of the palms of my hands.). On 22-Sep-2021, the patient experienced TACHYCARDIA (tachycardia) and HYPERTENSION (hypertensive). The patient was treated with CETIRIZINE HYDROCHLORIDE (ZYRTEC [CETIRIZINE HYDROCHLORIDE]) for Adverse event, at a dose of UNK, bid and FAMOTIDINE (PEPCID [FAMOTIDINE]) for Adverse event, at a dose of UNK, qd. On 23-Sep-2021, GASTROOESOPHAGEAL REFLUX DISEASE (severe acid reflux (never had in my life)) and INFLUENZA LIKE ILLNESS (Flu-like) had resolved. At the time of the report, CHRONIC SPONTANEOUS URTICARIA (Chronic Spontaneous Urticaria), MECHANICAL URTICARIA (dermatographia), URTICARIA (I began to experience full body hives predominantly behind my neck and ears, my torso, and my groin area/wheals), FEELING HOT (warmth), PRURITUS (itchiness) and ERYTHEMA (Erythema) had not resolved, MALAISE (malaise), CHEST DISCOMFORT (Chest tightness), WHEEZING (expiratory wheezing), COLD SWEAT (Cold sweat), PAIN (burning pain / Stabbing pain), TACHYCARDIA (tachycardia), HYPERTENSION (hypertensive), RASH (A rash also appeared on both of the palms of my hands.), FATIGUE (Fatigue), CHILLS (Chills), MYALGIA (Myalgia) and PYREXIA (Fever between 100-102 deg F) outcome was unknown and PERIPHERAL SWELLING (swelling of both of my fingers and palms on each hand began) and DYSPNOEA (slight difficulty in breathing) was resolving.      DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 20-Sep-2021, Body temperature: 100-102 (High) 100-102 deg F. On 22-Sep-2021, Body temperature: afebrile (normal) Afebrile. On 22-Sep-2021, Mononucleosis heterophile test: negative (Negative) Mono negative. On 22-Sep-2021, SARS-CoV-2 test: negative (Negative) negative. On 22-Sep-2021, Streptococcus test: negative (Negative) Strep negative.    On 20 Sep 2021 hives covered most of body's surface area and would last for hours at a time.  On 21 Sep 2021 the symptoms of the previous day worsened.  On 22 Sep 2021 the symptoms had not improved so went to urgent treatment clinic. Received a Intramuscular steroid shot, prescribed a Steroid 6 day dose pack, and told to take Zyrtec and Pepcid twice a day each for one week.  On 23 Sep 2021 hives disappeared, as well as the flu-like and reflux symptoms. Hand symptoms improved as well. The difficulty breathing slightly improved. Breathing would take another two weeks to return to normal.  On 28 Sep 2021 steroids were discontinued. Later that day my hives returned but were less severe. The wheals were smaller and more pinpoint. Had red streaks of urticaria that would arise either spontaneously or in the form of dermatographia. They still would appear in any part of body. Ears, fingers, and toes would randomly get red and warm as well. Taking Zyrtec twice a day and Pepcid AC once a day would lessen the frequency of symptoms, but there were always still breakthrough hives. Since then for the past 4 months have had these same symptoms daily. If do not take Zyrtec, the hives, itchiness, and dermatographia increase in frequency. The hives typically last in the affected area for 30 min to one hour. Over time, the hives and itchiness are decreasing in frequency throughout the day.