Age: 51.0
Sex: F
Vaccine: VARZOS
Symptoms: Musculoskeletal stiffness, Myalgia, Nausea, Pain, Pain in extremity
Clinical narrative: Symptom Summary - (see "continuation page" for timeline & detail) o Significant pain in a corset-like ring around trunk of body - skin, muscles, seemingly internal organs  both left and right sides (hrs. 12  60 after vaccination) o raised rash & prickling in band on left side of trunk  emerges aprox. 60 hrs. post vaccination o Rash develops blisters  aprox. 72 hrs. post vaccination; blisters grow in size over next several days Accompanying the above -  o fatigue  o nausea  o mild headache o dizziness/clumsiness o Muscle/tendon pain, skin sensitivity, tingling in left leg, knee, hand, arm, shoulder o No fever Additional information for Item 11: neurally mediated hypotension (similar to POTS, diagnosed by Dr. aprox. 1990)  Symptom Timeline - Wednesday  6/29/22, Shingrix vaccination about 10 a.m. o Sore arm  went for walk in evening; felt well, except for sore arm o By bedtime, pain in torso in a ring (corset area) around body        o Skin - very tender, painful and raw, similar to a burn, but not red, inflamed, hot or swollen.        o Muscle pain in the same area - soreness from ribs to lower abdomen and top of hips.        o Nausea      o tender stomach o Pain on sides, back, front  mostly left and right of centerline on both front and back  o Overnight - very painful to move, sit up, walk, lay down.  Hard to find a position to sleep that was okay to allow sleep.  Awakened by pain and nausea through the night and made it difficult to fall back asleep. o Mild headache o No fever  Thursday -  6/30/22 o pain continues as above  pain seems to be not only skin and muscles, but also internal organs. Abdominal pain and also higher by/under rib cage  maybe where kidneys are  really excruciating; mostly on left and right of center in back and front from rib cage to just below hip bones.   o Now, intermittent dizziness and clumsiness.   o Painful to walk.  Painful to sit upright.   o Hard to concentrate or think as clearly as usual. o Fatigued; small amounts of movement or sitting up are exhausting; must lay with legs elevated to recover. o Abdominal pain with some gas/flatulence.  o Mild headache  Friday  7/1/22 o Continuation of previous symptoms. o Muscle/internal pain seems to migrate down a bit.  Less under rib cage, more in abdomen, but remains in both places.  Pain in skin from hip bones down to legs (upper hip area); some pain/stiffness in muscles here, too. o Rash  at bedtime, discover rash on left side of trunk, bumpy  as though may form into blisters; rash is painful in a prickly way in addition to previous raw/burnt sensation. o Pain in left leg  in evening, pain starts down left leg in skin of inner thigh and in connective tissue/muscles where leg meets groin.  Saturday  7/2/22 o Continuation of previous symptoms. Overnight was not quite as bad.  Pain subsiding in injection site, but persisting in trunk. o Pain in left leg        o expands to skin and muscle along front of thigh above knee; knee is painful and somewhat swollen (more fluid in joint than right knee for comparison)      o pain in leg keeping awake  walked loops in house, because trunk/back pain while still present and worse with motion, was now not so bad as to prevent walking, fatigue had subsided and felt that movement & blood flow might help alleviate leg pain. o Rash  expanding and more red/angry, feels more thick and stiff, rash is painful; appears to be forming small pin-prick size blisters.  Sunday  7/3/22 o Injection site is only mild pain now, have full range of motion, pain if touch, but otherwise not bad. o Skin (aside from rash) pain in trunk  not gone, but improving; skin painful above knee o Muscle pain  improving; worst remaining muscle pain is in back on either side of spine.   o Leg/knee  pain continues above knee, in inner tendon along side of knee, behind knee o Rash  expanding, red and filling in between bumps, blisters have emerged and enlarged, painful, thick, stiff o Abdominal pain is largely resolved except for some tenderness and slight nausea in center of lower abdomen.  Gas/flatulence has resolved. o Fatigue  improved, still need to rest after moving  o Shooting pain in heal of left hand  sudden onset while trying to fall asleep Sun. night o Start 7-day course of Valacylovir HCL, 1 g tab., 3x daily (every 8 hrs) for 7 days  Monday  7/4/22 o Rash  red, angry, large blisters o Mild nausea and lower abdominal tenderness continues o Fatigue near end of day, improved; able to move with less pain  o Pain in hand/arm/shoulder        o initial pain in heal of hand has expanded along skin towards pinky finger  both surface and internal pain; skin hurts when touched;       o pain runs from hand up arm (pain in hand, brachio radialis near elbow, deltoid, and trapezius)  Tuesday  7/5/22 o Rash  red, angry, stiff, blisters even larger o Pain continues in -        o Leg/knee      o Hand/arm/shoulder - (hand - pain/tingling in palm along MCV joints, down side below pinky to heal)