Age: 41.0
Sex: F
Vaccine: FLU3
Symptoms: Decreased appetite, Fatigue, Feeling cold, Headache, Immune complex assay
Clinical narrative: Female who reports receiving 1/2 dose of AFLURIA vaccine in her left upper arm mid-afternoon on 9 OCT. She took her first dose of Ibuprofen 800 mg within 1 hour of vaccine receipt, and then continued to take this dose approximately every 8 hours (3 times per day) over the next 5 days. She denies any unusual or prolonged local reaction at the vaccination site. Around 2000, on the evening of vaccine receipt, patient felt more tired than usual, had a mild throbbing headache, generalized aching, and a sore throat. She denies fever or chills. She went to bed and slept through the night. On post-vaccine day (PVD) 1 (10 OCT), patient awoke with a headache that remained dull and throbbing throughout the day, despite taking Ibuprofen. (No decrease in pain intensity of headache following doses of Ibuprofen.) She felt more tired than the previous day, and she experienced "waves of nausea", with a decrease in appetite. She forced herself to eat, but did not push fluids. That afternoon, she experienced post-nasal drainage and rhinorrhea, as well as a continued sore throat and watery eyes. She did not develop a cough, wheezing, chest tightness, or facial edema. She denies vomiting or diarrhea. On PVD 2 (11 OCT), patient felt drained. Her aching was worse, but did decrease after she took doses of ibuprofen. Her upper respiratory symptoms and headaches began to wax and wane. That evening, she had difficulty going to sleep and sleeping through the night. By 12 OCT (PVD) 3, her rhinitis and throat symptoms had resolved. Regarding myalgias, headaches and fatigue, they were improving very gradually. Her nausea and decreased appetite continued, as well as her difficulty sleeping. (Denies difficulty with sleep being related to headaches, myalgias or other symptoms). She felt cold - "freezing" with chills, but no fever. She rested as much as possible over the weekend of 13 and 14 OCT. Over the next week, "it was more of the same". All of her symptoms resolved after about 2 weeks, with nausea being the symptom lasting the longest. Patient reports feeling fine on the day of vaccine receipt, with no recent infections or viral symptoms. She reports tolerating other vaccines without reactions, but prior to this year's flu vaccine, patient reports having a reaction to multiple doses of flu vaccine in the past. Prior to this year's flu vaccine, the last flu vaccine she took was in SEP 2004, which was given in her buttocks. Her reaction included body aches, headaches, extreme fatigue, chills, nausea and decreased appetite. Symptoms were severe enough, that she was bedridden for 7-10 days, and symptoms did not completely resolve for 2-3 weeks. During that course of time, she lost 7 pounds. She denies any fevers, local site reactions, hives, angioedema, respiratory symptoms, vomiting, or diarrhea. Prior to SEP 2004, she had not taken flu vaccines since the mid-90s - "took a break because of reactions each year". She reports similar episodes on more than 2 occasions within 3-4 days of receiving flu vaccines. She has never taken the FLUMIST vaccine.