This case was reported by a consumer and described the occurrence of shortness of breath in a female subject aged between 50 and 59 years old who was vaccinated with TWINRIX (GlaxoSmithKline). A physician or other health care professional has not verified this report. The subject's medical history included thoracic outlet surgery. Concurrent medical conditions included depression and high blood pressure. Concurrent medications included Lisinopril, Naproxen, TYLENOL, BENADRYL and LEXAPRO. In 2007, the subject received 1st dose of TWINRIX in the right arm. One day later, she reported experiencing shortness of breath, a heaviness in her chest, headache and sinus problems. She also reported pain at the injection site. The subject reported that the symptoms lasted about a week. Injection site pain continued. The subject reported that if she pushed on the injection site it still hurt. On an unspecified date, the subject received a 2nd dose of TWINRIX in the right arm. The day after receiving TWINRIX, she developed heaviness in her chest (similar to allergies), difficulty breathing (for a few days), a runny nose, and injection site pain. The events lasted about one week. In early 2008, the subject received a 3rd dose of TWINRIX. One day later, she developed a headache. The headache resolved with nitrofurantoin macro treatment, but returned about a week after she stopped taking nitrofurantoin. It was reported that the headache lasted for two years. Other adverse events noted following the 3rd dose of TWINRIX; Joint pain began "right after" she received the 3rd dosage in the series. She reported that the joint pain was not bad at first. She reported pain in her hands while doing computer, data entry work. She reported her joint paint got better but was still there while she was taking nitrofurantoin. At the time of reporting, the subjects joint pain was worse. She reported it being all over. Her jaw was painful after she talks. Her hips and knees hurt badly when she walks. She was operated on in 2000 for thoracic outlet syndrome and it had been corrected completely. Because these symptoms had gone on for so long, she reported she thought she was suffering from thoracic outlet syndrome. She thought this was the same because she had so much pain in her legs, knees and hips. The subject reported swelling all over, especially in her legs. She reported leg pain. Other areas included around her head, temples and hands. The swelling was first noted in the summer of 2008. The subject reported receiving an unspecified medication for swelling. She had been seen in the emergency room three times. Headaches were reportedly so bad that the subject gets sick to her stomach. She reported having trouble thinking, which she felt had improved and stiffness to the point she is unable to move. She had been on nitrofurantoin three different times. She additionally reported being treated with unknown medication for depression. Specifically at the time of reporting, shortness of breath was resolved, heaviness in the chest was resolved, headache was unresolved and sinus problems were worse. Follow-up information was received on 22 March 2010 via subject who reported she received the 1st dose of TWINRIX in August 2007, 2nd dose in September 2007 and 3rd dose in March 2008. Follow-up information was received on 05 April 2010, via healthcare professional, who stated the subject did not receive TWINRIX at their office; she was not seen by this healthcare professional until 23 July 2009.