Well on the same day she vomited, had a fever I feel like that COVID 19 vaccine made her sick, and for me that’s not right

PT STATED THAT WITHIN ABOUT 2 HOURS AFTER RECEIVING THE SHINGRIX IMMUNIZATION, HER UPPER ARM STARTED HURTING A LOT ABOUT 2 INCHES BELOW THE AREA OF THE SHOT. SHE WAS ALSO SWEATING AND HAD SIGNIFICANT NAUSEA.

Pt complains of increasing pain and decreased movement of R shoulder, with symptoms starting to worsen 48 hours after injection. No redness, swelling, or rash at site. States that it has been painful as she moves her shoulder from body and when she raises her arm above her head.

fever, facial hives and eye swelling approximately 5 minutes after vaccine administration. Patient given Benadryl and Ibuprofen. Observed for 20 minutes after medication administration with resolution of facial hives and eye swelling. One hour later, fever resolved per parent report over the phone.

Patient presented to ER at outlying facility complaining of chest pain, vision changes (tunnel vision), ears ringing, near syncope, dizziness, pale, clammy, flushing of skin, chest tightness, weak, sluggish, and fatigue. He was evaluated at ER on 1/16/25 and everything on exam reported to be benign. Patient has since followed up with us to be evaluated by his PCP on 1/17/25 and again 1/24/25 and is still continuing to have lingering symptoms, reporting lightheaded, joint pain, shaky, dizzy, nausea, decreased appetite, and difficulty sleeping. PCP Dr. is suspicious this is post influenza vaccination reaction with neurological involvement and encephalopathy. We will continue to follow up with patient and his symptoms.

Patient received 3rd dose of HPV, when only needed the 2 dose series. No symptoms or side effects noted.

No adverse reactions.

The nursing assistant gave a second flu shot to this member. No adverse effects.

L shoulder pain immediately after vaccine administration and chronically for months following.

Left deltoid superior aspect with small eschar and no local redness, inferior aspect of deltoid, small eschar with local redness and mild edema, pink/violaceous irregular rash inferior to deltoid but congrunet with inferior injection site. Superficial tactile sensitivy but no significant induration, no soft tissue or bony defect. Distal to mid portion of upper arm is slightly pale lacey purplish/mottled area. Distal forearm and hand normal. Notes: MCV-4 appears to be the presumed trigger for this fixed local reaction. It’s expected to diffuse in the next 3-4 days. May migrate with gravity. May treat locally with ice/heat if needed, may continue experience sensory sensitivity of skin until rash is resolved. Discussed okay to tentatively plan to repeat vaccine when due at 16 years. Fixed local reaction does not appear to be in the spectrum of allergy with risk of systemic allergy or dangerous consequences. Patient is uniquie in circumstances as his liklihood of reaction may be a reflection of the pooled immunoglobulin he gets for his hypogammaglobulinemia. May address with Immunologist if parents wish. VAERS report to be filed.