Age: 65.0
Sex: F
Vaccine: COVID19, VARZOS
Symptoms: Arthralgia, Ear pain, Headache, Herpes zoster, Herpes zoster oticus
Clinical narrative: Stress levels that get high; Her immune system gets lower; Left arm is in pain for a week and half like someone beat her with a bat; Doesn't want to experience this pain while she is working/pain behind ears; her neck and shoulder and the pain so she couldn't turn her head to the left; From her neck and shoulder and the pain so she couldn't turn her head to the left; She couldn't turn her head to the left; shingles attacked her head- shingles / herpes zoster virus/herpes zoster in her arm/Possible shingles after receiving the shingles vaccine; Arm where the shot was given shot  is with a muscle ache / very bad muscle pain when she lifts her arm; shingles attacked her ear; Her lymph nodes in her neck and face swollen; Had pain in her ear / pain behind her ear; Headache; Her neck was swollen/she was all swollen; the pain in her ear, her right ear all the way to her shoulder she thought was a pinched nerve./massage therapist told her it was not a muscle it was a nerve/nerve in her ear gets attacked/nerve ending is there; This case was reported by a consumer via licensee and described the occurrence of herpes zoster otitis externa in a 65-year-old female patient who received Herpes zoster (Shingles vaccine) for prophylaxis.   Co-suspect products included COVID-19 VACCINE (COVID 19 VACCINE) (batch number EN6198, expiry date 30th June 2021) for prophylaxis.   The patient's past medical history included bell's palsy (patient had bell's palsy twice due to herpes zoster virus), meningitis (patient had bell's palsy twice due to herpes zoster virus) and nerve compression (patient had pinched nerve about 2 months from the time of reporting). Concurrent medical conditions included mitral valve prolapse (patient has mitral valve prolapse and her heart is a little enlarged in the middle) and esophageal acid reflux.   On 2nd February 2021, the patient received the 1st dose of Shingles vaccine. On 23rd February 2021 15:30, the patient received the 1st dose of COVID 19 VACCINE. On 2nd February 2021, less than a day after receiving Shingles vaccine and an unknown time after starting Valtrex, the patient experienced headache. On 7th February 2021, the patient experienced neck swelling. On 25th February 2021, the patient experienced herpes zoster otitis externa (serious criteria GSK medically significant), lymphadenopathy cervical, ear pain, shingles and muscle pain. On an unknown date, the patient experienced stress, immune system disorder, pain in arm, pain, neck pain, shoulder pain, mobility decreased and pinched nerve. The patient was treated with valaciclovir hydrochloride (Valtrex) and ibuprofen + paracetamol (Advil Dual Action). On an unknown date, the outcome of the herpes zoster otitis externa, headache, neck swelling, lymphadenopathy cervical, shingles, muscle pain, pain in arm, pain, neck pain, shoulder pain, mobility decreased and pinched nerve were recovered/resolved and the outcome of the ear pain was not recovered/not resolved and the outcome of the stress and immune system disorder were unknown.   It was unknown if the reporter considered the herpes zoster otitis externa, headache, neck swelling, lymphadenopathy cervical, ear pain, stress, immune system disorder, shingles, muscle pain, pain in arm, pain, neck pain, shoulder pain, mobility decreased and pinched nerve to be related to Shingles vaccine.  Additional details were provided as follows: The reporter was the patient herself. The patient did not have much for medical history but one thing she had was mitral valve prolapse which worries her and her heart was a little enlarged in the middle. Another condition was acid reflux but she stated that everyone had that condition.  In the past, patient had the bell's palsy and meningitis twice with the herpes zoster virus, the same virus that attacked her ear and her head- shingles. She had knowledge that those viruses attacked her in the past. The patient had pain that she had maybe about 2 months ago, the pain in her ear, her right ear all the way to her shoulder which she thought was a pinched nerve. Her son had a puppy and she played with him and she thought it was a pinched nerve. She went to get a massage and the massage therapist told her it was not a muscle it was a nerve. The nerve in her ear got attacked. She had gone to a walk in clinic and they didn't recognize that it was the herpes zoster virus.It could be the neck and then they didn't recognize the herpes zoster virus. The patient was given Valtrex and that medicine had helped her before as well, so then she took the Valtrex. The patient want an appointment with her doctor and she would have liked to have tests to check and see, but they didn't schedule her. The patient had received the Shingles vaccine around 2nd February 2021 before the Covid-19 vaccine in order to be preventive. The patient did not have NDC/Lot number or expiry date of Shingles vaccine. The patient had a headache in the evening, then on Friday she did not have anything. She noticed then on Saturday that she had got the reaction, then on Sunday she was all swollen, then it continued into Monday, Tuesday and Wednesday. The patient also had received Covid-19 vaccine (Pfizer product) on 23rd February 2021 which expires on 30th June 2021. Two days after she had the Covid 19 vaccine, her neck was swollen, lymph nodes were swollen in her neck and face, she had pain behind her ear and her arm where the shot was given was with a muscle ache.  When she had stress levels that got her high, her immune system got lower and hence she got a virus like bells palsy, meningitis and also some kind of shingles.She wont break out on the skin but the nerve ending was there behind her ear.  She lifted her arms above and her left arm was in pain for a week and a half like someone beat her with a bat.  The patient experienced possible shingles after her Shingles vaccine. She took ibuprofen and she called her doctor and they told her to take ibuprofen.She called her physician and with the nurse she was told to take an Advil, she further reported that her doctor and nurse don't care.  She was apprehensive with the second dose of Covid-19 vaccine because she got reactive with the first one.  She was 65 years old and she cannot afford to get Covid but she did not want to experience such pain while she was working.  Her doctor took a week to respond, then she started reading on vaccines and its side effects, people were having those experiences on their first dose of vaccines. The reporter states that if someone experiences those kind of experiences, they should kindly call the hotline and seek help. The patient just wanted the vaccine to be beneficial to her.At this point she really does not know what was to be done, she did not want to be afraid of the Covid 19 vaccine as she knew that the benefits were greater than the risk. She was also apprehensive with the first Covid 19 vaccine.  The patient want to take her second shingles vaccine after the second Covid vaccine. The patient was taking the ibuprofen for a little bit but then the pain came back.  The patient would be getting the second Covid-19 vaccine on 16th March 2021. Later in the call, she clarified that the virus she was speaking of was the herpes zoster virus or also known as shingles. The patient was going to change her doctors as she did not like the little care they had for someone experiencing something like those events.  The patient thought if this was related to her Covid-19 vaccine so she started reading more about what the vaccine could do to the patient and it had a side effect and it said in there and she misread during her paperwork and it was considered severe if she had swelling on her face and throat and she ignored her paperwork.She read that and decided to call. That was what she experienced with her lymph nodes, and from her neck and shoulder and the pain such that she couldn't turn her head to the left, and she thought maybe it was a pinched nerve and she always thought something else was bothering her.  She was taking Valtrex for the virus that caused bells palsy and that made it better(shingles/herpes zoster).  She started healing with that medicine and she knew it wasn't a pinched nerve and that it was the shingles/herpes zoster that attacked her. She was better on the reporting date but still had pain behind her ear.  She knew a doctor that had the same situation with this virus (shingles or herpes zoster) and she went blind.When the doctor did her eyes and got the Lasix surgery, she had the virus attack her and she called it the herpes virus, the secondary or whatever they call it. It was related to chicken pox and she got the virus when she was a kid, then it laid dormant and 10 to 15 years before the time of reporting, when that doctor went blind, if the doctor had known she would have taken the Valtrex prior to her Lasix surgery.She had been to the emergency room with her meningitis and the doctor explained it to her. The patient clarified again that she never had the shingles rash breakout on her skin, but had the nerve part of it., she had symptoms for 3 weeks and they wanted to send her for neurology and MRI and she told them to give her the Valtrex and she took it for 7 days and her symptoms disappeared completely.  Only reason she thought it was the herpes zoster virus was because she got the Covid 19 vaccine in her left arm and it was the same area and the same thing only but this time it wouldn't go away completely, but it was her arm which felt like someone had hit her with a bat.  She had very bad muscle pain when she lifts her arm. The reporter confirmed Covid-19 vaccine date as 23rd February 2021 (first dose). The patient was treated with Valtrex (Valacyclovir Hcl 1gm tablet 1 per day usually at night in a pharmacy bottle) which should be discarded by 5th November 2021. The patient also took Advil Duo Action which had 250mg acetaminophen and 125mg ibuprofen  (2 caplets in the morning and one caplet at night) with lot number DN7584 and expiration date of August,2022.  The patient had product complaint regarding Advil Dual Action (Ibuprofen). It was unknown if the reporter considered the herpes zoster otitis externa, neck swelling, lymphadenopathy cervical, ear pain, stress, immune system disorder, shingles, muscle pain, pain in arm, pain, neck pain, shoulder pain, mobility decreased and pinched nerve to be related to Covid-19 vaccine. The reporter consented to follow-up and also gave consent to follow-up with health care professional.