Age: 28.0
Sex: F
Vaccine: FLU4
Symptoms: Pain, Pruritus, Reaction to preservatives, Skin test positive, Swelling
Clinical narrative: Received the employee required flu vaccine on 9/20/19 at the Occupational Health Office. By 9/22/19, reactions started to occur. Reactions consisted of rash: hives, itching, redness, swelling, inflammation, and severe pain of the chest, neck, and face. From these symptoms, I was unable to sleep or function in daily life because of pain and other symptoms mentioned starting on 9/22/19. This rash and the symptoms interfered with work and then ability to wear hospital OR gowns during the scrub rotation of the Program. The gowns rubbed against the rash on my neck which further aggravated the rash.   I went to primary care doctor on 10/3/19 to get evaluated and for lab to be drawn. Labs tests showed increase in lymphocytes and eosinophils- the primary care doctor concluded an allergic reaction to something in my body.  On 10/4/19 I took the day off because of how severe the allergic reaction was. On 10/4/19 I went to the allergist first thing in the morning with the same reactions as mentioned plus had a hoarse and sore throat due to the extensive inflammation around the neck/throat area. Allergist prescribed Prednisone 40mg for 5 days and a steroid cream- Triamcinolone Acetonide Ointment 0.1% as needed for rash. Took prescribed Prednisone for 5 days, and 2 days later, rash returned: hives, itching, redness, swelling, inflammation, dryness, and severe pain of the chest, neck, and face. Side effects of Prednisone was severe (insomnia) that it was not recommended to take again along with the side effects of the steroid cream (extremely dry/painful skin). Allergist recommended patch testing to see if any chemicals or metals that may be reacting to my body. Patch testing was available after waiting 2 weeks after the last dose of Prednisone so the steroids will not interact with the results of the patch testing.  Patch testing was placed on 10/28/19, first patch test read and removed on 10/30/19, and final read on 11/1/19. Results from the patch testing showed allergic response to Thimerosal. In addition, took off work on 10/29/19 due to lack of sleep from the rash and symptoms of the rash (hives, itching, redness, swelling, inflammation, and severe pain of the chest, neck, and face).  I have been taking Benadryl and Claritin to try to ease the symptoms with little luck. I went to another allergist on 10/29/19, and he prescribed montelukast, zyrtec, and hydralazine to help with the inflammation, allergic reaction, and sleep (but with little luck, the symptoms of the effects of the flu shot still persists).   Rash has continued to this day and has spread to other areas of the body- entire face/ears, traps, upper back, and arms (starting around 10/14/19). The rash and effects of the flu shot is still currently affecting everyday life including effecting work (concentration/ coming in to work/ wearing OR scrubs and normal clothing) and ability to sleep at night. The lack of sleep interferes with work as well. As mentioned, the rash is currently still very itchy, red, swollen, dry, with inflammation, and severe pain of the chest, neck, and face.