This case was reported by a physician and described the occurrence of injection site itching in a 80-year-old female patient who received SHINGRIX. The patient's past medical history included senile lentigo. Previously administered products included ZOSTAVAX (a number of years ago). Concomitant products included MIRALAX, biotin, CALTRATE, CRESTOR, latanoprost and MURO 128. In April 2018, the patient received SHINGRIX. In April 2018, 2 days after receiving SHINGRIX, the patient experienced injection site itching, leg edema, urticaria, labored breathing, itchy legs, allergic reaction, redness of legs, inflammation localized and generalized pruritus. On an unknown date, the outcome of the injection site itching, leg edema, urticaria, labored breathing, itchy legs, allergic reaction, redness of legs, inflammation localized and generalized pruritus were unknown. It was unknown if the reporter considered the injection site itching, leg edema, urticaria, labored breathing, itchy legs, allergic reaction, redness of legs, inflammation localized and generalized pruritus to be related to SHINGRIX. Additional details were provided as follows: The patient's concomitant medication included allergy 10 mg tablet, CENTRUM ULTRA WOMEN'S VITAMIN, CLIMARA PATCH and MYBERTRIQ. The patient received her vaccine last Monday and early morning of Tuesday she woke with really itchy legs (lower front legs, both sides). The patient said they were not as itchy during the day but it continued to wake her up over the next few nights. The reporter saw her on Thursday and the patient showed him her legs, they were red and inflamed, she indicated they were still very itchy (if it had only been one leg involved, reporter would have probably told her she had shingles just based on the way they looked, being the physician that he was not). On Friday it apparently got worse, with her wrists itching. The patient went to the physician Saturday morning, at which time she had started to break out in hives, and was itching all over. They determined it was an allergic reaction to the vaccine (the reporter would concur, she had not eaten anything unusual, had not changed laundry detergent, had not changed medications and the itching started less than 24 hours after shot). She received a steroid shot, the reporter saw her Saturday afternoon and also realized her breathing was labored during activities that should not have left her quite so breathless (she was 80 but in extremely good health and walks 1 to 2 miles most days, including some pretty substantial hills). The shot took care of the problem. The patient was insisting she get the 2nd vaccine rather than shingles. Not so sure that was a smart idea, the reporter would leave that to her and her physician. The patient thought the redness on her legs might had been caused by using water that was too hot. She had extremely thin skin, much thinner than you normally see on older people, any open cut on her lower legs was likely to send her to a wound physician so there could be validity in that. She was on a few medications, one for her eyes and the reporter thought that a bladder medication, but no heart medications, diabetic medications and cholesterol drugs. The reporter did not have some pictures she took, but her legs with age spots and damage from the thin skin, were not that easy to see what was going on (except the redness).