she lost sleep for 3 days; shoulder drop is very noticeable/ her shoulder physically dropped; feel the small lump on her arm; body ache; diagnosed her with impingement; redness moved from going down the arm towards the muscle as if she got brain freeze; arm was beat, hot, and inflamed; itching on her upper arm; a little bit of swelling; horrible bone pain in her shoulder/ shoulder pain/ joint pain; arm was red/ redness in her arm; nerve pain along the inner aspects of axillary when she's flexing her arm/ nerve pain; got chills and can't get her body to be warm like her whole body is cold; Initial information received on 05-Oct-2023 with live follow up processed together CSD: 05-OCT-2023 regarding an unsolicited valid  non-serious case received from a consumer/non-hcp (non-healthcare professional).  This case involves a 76 years old female patient who had nerve pain along the inner aspects of axillary when she's flexing her arm/ nerve pain, she lost sleep for 3 days, shoulder drop is very noticeable/ her shoulder physically dropped, feel the small lump on her arm, body ache, diagnosed her with impingement, redness moved from going down the arm towards the muscle as if she got brain freeze, arm was beat, hot, and inflamed, got chills and can't get her body to be warm like her whole body is cold, itching on her upper arm, arm was red/ redness in her arm, a little bit of swelling and horrible bone pain in her shoulder/ shoulder pain/ joint pain after receiving RSV vaccine and influenza quadrival A-B high dose HV vaccine [Fluzone High-Dose Quadrivalent].  The patient's past medical history, medical treatment(s), vaccination(s) and family history were not provided.  On 28-Sep-2023, the patient received a dose of suspect influenza quadrival A-B high dose Hv vaccine (with an unknown strength, formulation) at a dose of 0.7 ml total  (lot UT8104AA, expiry date- 30-JUN-2024 ) via intramuscular route in the right arm and received a  dose of suspect RSV vaccine not produced by Sanofi Pasteur (with an unknown formulation, expiry date, dosage, strength, lot number not reported) via unknown route in the left arm for Immunization. Information on the batch number was requested for RSV vaccine.  On 28-SEP-2023, (latency- same day)  the patient got chills and can't get her body to be warm like her whole body is cold (chills) following the administration of influenza quadrival A-B high dose HV vaccine and RSV vaccine.  On 29-SEP-2023, (latency- 1 day) the patient developed nerve pain along the inner aspects of axillary when she's flexing her arm/ nerve pain (neuralgia) and arm was red/ redness in her arm (vaccination site erythema) following the administration of influenza quadrival A-B high dose HV vaccine and RSV vaccine.  On an unknown date, (unknown latency), the patient lost sleep for 3 days (insomnia), shoulder drop is very noticeable/ her shoulder physically dropped (dropped shoulder syndrome), diagnosed her with impingement (joint impingement), feel the small lump on her arm (vaccination site mass), redness moved from going down the arm towards the muscle as if she got brain freeze (cold-stimulus headache), a little bit of swelling (vaccination site swelling),  itching on her upper arm (pruritus), arm was beat, hot, and inflamed (vaccination site inflammation), body ache (pain) and horrible bone pain in her shoulder/ shoulder pain/ joint pain (arthralgia) following the administration of influenza quadrival A-B high dose HV vaccine and RSV vaccine.  Reportedly, Patient said that it has been a week and there's still itching on her upper arm. Patient mentioned that she went to emergency care on Sunday, 01Oct2023, because her arm was beat, red, hot, and inflamed. Patient's physician diagnosed her with impingement. At the time of the call, patient still experiences itching, a little bit of swelling, a little redness fading on her upper right arm and that her shoulder drop is very noticeable. Patient stated she wanted to report the reaction because her bone pain is getting high up into the deltoid and since she's not sure if it was given in the deltoid or how it was angled. Patient said she has had the FLUZONE QIV HD since it was offered but she never had a reaction to it. she is scheduled to go to physical therapy. Physical therapy will start on 10Oct2023.Patient mentioned she got the RSV vaccine on her other arm the same day she received the FLUZONE QIV HD. She said she had no problems with it but the symptoms can be relative to the vaccine as well. Patient has to get her COVID vaccine but stated she had to wait until she can get it.  Action taken was not applicable.  The patient was treated with Meloxicam, Ibuprofen, Ice packs, Tylenol at night, Physical therapy for all the events.  At time of reporting, the outcome was Unknown for the event horrible bone pain in her shoulder/ shoulder pain/ joint pain; nerve pain along the inner aspects of axillary when she's flexing her arm/ nerve pain; a little bit of swelling; got chills and can't get her body to be warm like her whole body is cold; she lost sleep for 3 days; shoulder drop is very noticeable/ her shoulder physically dropped; feel the small lump on her arm; body ache; arm was beat, hot, and inflamed; diagnosed her with impingement and redness moved from going down the arm towards the muscle as if she got brain freeze, was Not Recovered / Not Resolved for the event itching on her upper arm and was Recovering / Resolving for the event arm was red/ redness in her arm,.