Age: 36.0
Sex: F
Vaccine: MMR
Symptoms: Back pain, Dyspnoea, Fatigue, Insomnia, Malaise
Clinical narrative: Information has been received from a health professional concerning a 36 year old female pt who is currently a smoker, has no drug allergies, and received 2 previous doses of measles virus vaccine live (+) mumps virus vaccine live (+) rubella virus vaccine live (second generation) as a child, who on 09/06/2002 was vaccinated by subcutaneous injection with a third dose of measles virus vaccine live (+) mumps virus vaccine live (+) rubella virus vaccine live (second generation) (MSD) (Lot #642180/0186M). There was no concomitant medication. The pt had no illness at the time of vaccination and no adverse events with prior vaccinations. On 09/10/2002 at a follow-up physician visit it was noted that the pt had developed myalgia, fever, sore throat, fatigue, shortness of breath, back pain, jaw pain, neck tenderness and insomnia. The reporter indicated the pt's lungs were clear and iron levels were noted to be low. On 09/23/2002 the pt was seen in the ER at a medical center for continued back pain, which was described as "right side and back tenderness". A chest X-ray was negative: the report showed the lungs were fully expanded and clear bilaterally, no pneumonia, or congestive failure, the pleural spaces are free of fluid, the heart, mediastinum and pulmonary hila was normal and bony thorax was intact. The chest X-ray impression reported a normal chest. It was noted the ER physician diagnosed pleurisy secondary to measles virus vaccine live (+) mumps virus vaccine live (+) rubella virus vaccine live (second generation) (MSD). The reporter indicated the physician had said, "it was a clinical judgement call (since her X-ray was negative)". The pt was released from the ER and her treatment medications included acetaminophen (+) oxycodone hydrochloride (PERCOCET) for pain, ibuprofen, rofecoxib (MSD) and albuterol sulfate (PROVENTIL). The pt subsequently developed a rash while on therapy with rofecoxib (MSD) (WAES #0210USA00006), which was reported to have resolved after the rofecoxib (MSD) was stopped. Follow-up info noted the previously reported fever of 103 degrees F, sore throat, malaise, and myalgia developed on 09/07/2002 and lasted one day. On 09/08/2002 the temperature was normal, malaise, muscle ache and sore throat had resolved, but she developed shortness of breath, pain across right back, right neck pain, pain to right middle back and lower back. Additional info also noted the pt developed joint pain to wrist and ankles approx three days after injection that lasted 2 weeks. It was noted the insomnia was related to pain and shortness of breath while lying in bed. The neck pain lasted approx 2 days; shortness of breath lasted approx 2 weeks, and the pt claimed she never had jaw pain. Additional info indicated stated the pain to her right middle and lower back continues, but is no longer continuous; and it is now intermittent and mild when she takes a deep breath, or is lying on right side. The reporter indicated the pt stated "I think it is still there because it is painful when I take deep breaths and sometimes at night in bed when I lay on that right side". The reporter indicated all have resolved except possibly pleurisy, and also indicated no other info is available regarding the pleurisy because the pt has not followed up with her primary medical doctor regarding the pleurisy. It was noted the pt has not had any loss of work time or any decline in activities of daily living due to the adverse event. Follow-up info received on 02/03/2003 from a physician indicated that the pt had recovered. It was noted in the pt's medical records that on 09/23/2002 the pt's heart rate was 90 and regular and pulse oximetry 99% on room air. It was also noted that the pt had a negative past medical history. The physician stated that the pt had not been seen since the 09/23/2002 ER visit. No further info is expected.