Age: 81.0
Sex: F
Vaccine: COVID19, FLU3, VARZOS
Symptoms: Mobility decreased, Pain in extremity
Clinical narrative: On 1/24/25 at approximately 1:00 pm patient received Shingrix shot in her left arm and Fluad (top) and Comirnaty (bottom) in right arm.  I discussed with patient about seperating Shingrix from Fluad and Comirnaty.  Patient said she was not going to come back out to get another shot and wanted to get all 3 today.  She insisted in 2023 on getting 4 shots together in one day due to the same reason.  She stated she was fine with 4 shots and would be fine with 3 shots.  I explained that the Shingrix shot had more side effects than the other.  She asked did the side effects last forever?  I said no it is commonly soreness, achy, fever etc for a couple days.  She said she would be fine.  Patient received all 3 shots.  After receiving the Shingrix shot first she made a comment to the effect of if things keep going this way I was going to be her gal as in the shot didn't hurt.  I administered all 3 shots and she did not have any issues while in store.  Patient called back after lunch saying she had lost her prescription that she picked up.  She did not mention her arm at that time.  She called back around 5pm and spoke to the pharmacist on duty, about pain in her arm.  Pt stated she had been putting hot compresses on and had taken either IBU or Tylenol.  Pharmacist on duty advised her to put cold compress and if not better possibly go to the doctor.  Pharmacist on duty asked patient to call back in an hour if not better.  Patient did not call back.  Around 6:56pm Heatlh System called and spoke to technician, about shots patient received.  They requested what immunizations patient received, what arm, manufacture, lot number and expiration date.  Dr. electronically sent in prescriptions after we closed for Hydrocodone 5/325 and Lidoderm 5% patch.  I spoke with patient around 9:57am on 1/25/25.  Right after dialing her number the patients neighbor came to the counter to pick up her prescriptions.  Neighbor stated that patient could not move her arm.  That doctor last night told her it did not hit a bone, blood vessel or shoulder joint.  Neighbor stated she gave her a 5% lidocaine patch and patient stated it did not help any.  Patient chose to get OTC 4% patches and the hydrocodone pills.  I spoke with patient and she stated she began to hurt after she got home approximately 30 minutes after shot.  She stated she has pain in her arm and some in her shoulder.  She went to Health System and they told her it was not uncommon to have reactions to Shingrix and that it takes 3-5 days for the pain to go away.  She stated she was not going to make it that long and she was going to go to the ER.  Patient stated she could move her arm any way she wanted but that it hurt a lot.  I repeated about the doctor stating that it wasn't uncommon to have side effects and she stated that he said it wasn't common to have side effects.  I asked if she was going to the ER and she stated she would take the medication when her neighbor delivered them and see if they helped.  I asked her to contact me later today to let me know how she was or that I can call her and check up.  She stated she would give me a call.