This case was reported by a lawyer and described the occurrence of arthralgia in a female subject of unspecified age who was vaccinated with LYMERIX (GlaxoSmithKline). A physician or other health care professional has not verified this report. On an unspecified date the subject received unspecified dose of LYMERIX (unknown). An unspecified time after vaccination with LYMERIX, the subject experienced arthralgia, flu-like symptoms, myalgia, shooting pains, autoimmune disease, activities of daily living impaired, body pain, memory problems, walking difficulty, lack of coordination in hands, rheumatological symptoms, neurological impairment, cognitive impairment and decreased activity level. At the time of reporting the outcome of the events was unspecified. The information in this case was received via a Statement of Injuries. Follow-up information was received on 13 April 2009 via medical records. Dating back to 04 September 1998, the subject underwent a physical exam for Lyme follow-up. She reported that she was much better. Joint discomfort, and headache were resolved with antibiotic and low energy and appetite were improved. A series of exams were documented dating from September 1998 through April of 2008. In May of 1999, the subject questioned relationship of recent Lyme vaccine to exacerbation of left shoulder pain. The examinating physician felt it unlikely due to the subjects history with this sort of problem. On examination, the site of LYMERIX was unremarkable. Increasing back pain was noted on 10 May 1999. On 27 January 2000,the subject complained of shoulder discomfort "bursitis" and that each morning her feet and hands were swollen. Physicals continued and on 16 March 2000, it was reported that the subject had tolerated a course of PREDNISONE for suspected PMR poorly with some jitteriness and palpitations. She did note that some swelling of the metacarpophalangeal joints did disappear. The subject described some swelling in the toes. It was noted that the subject had two of three Lyme vaccines. Concerns over Lyme vaccine precipitated arthritis were discussed. On 08 June 2000, fibromyalgia with seronegative rheumatoid arthritis was suspected, but not officially diagnosed. Treatment included PLAQUENIL, VOLATREN and FLEXERIL. Problems continued in March of 2001 and PLAQUENIL was discontinued as it did not appear to help. In March of 2002, the subject was not feeling well. She described feeling shaky, tired and achy since BACTRIM ran out. She was taking BACTRIM to treat arthritis symptoms. More BACTRIM was given. An EKG was normal. And her joints showed no sign of active arthritis. Problems continued in May of 2002. In September 2002 the subject was suffering from an incidental viral syndrome. Nothing significant was assessed otherwise. Then in October of 2002, the subject noted swollen left ear with no pain. MEDROL DOSE PAK with KEFLEX was given. This condition was followed on 15 November 2002 with the addition of swelling left side of face with some numbness and "feeling different". On 20 February 2003, the subject reported not feeling well. A positive Western Blot for Lyme disease was reported from back in November. She reported treatment with DOXYCYCLINE for one month which worked. Treatment were helping and were continued. The subject was evaluated on 18 June 2003 for arthritis. The subject reported being well until 1999. She received two doses of LYMERIX and approximately one month later developed generalized joint stiffness effecting the knees, feet, elbows and hands. There was also morning stiffness. After evaluation, inflammatory arthritis was diagnosed. In November 2003, the subject worried over some underlying heart problem but described no symptoms. Increased fatigue due to poor sleep habits was all that was noted. On 06 April 2004, the subject complained of itching skin with no rash. An incidental finding. Urinary tract infection was noted on 30 August 2004. Cipro was given. Racing heart was reported on 24 September 2005. Electrocardiogram was normal as well as physical exam. Complaints related to the subjects arthritis continued through documentation dated 17 April 2008. On 17 June 2008, the subject underwent a physical exam. After being bitten by several ticks, the subject developed muscle ache, joint complaints, headache and sore neck. The exam was reportedly unremarkable.