Patient expressed concern after the immunization that it was provided too high (provided by a technician under RPH guidance). On 1/22/25 patient reported to us that she had significant arm pain beginning the next day along with numbness from the shoulder to the fingers.

Patient and her wife came in together and asked for an RSV vaccine because their adult daughter has been severely ill with RSV for a month. They are under 75 years old, so I informed them that it was no longer indicated unless they had increased risk. They both said they were diabetic and in their late 60’s so wanted to go ahead and get vaccinated. I asked if they had ever gotten an RSV shot, both indicated that they had not, and our pharmacy software also did not show that they had gotten it as far back as our profiles show. We administered the vaccine to each of them. The next day, we were informed by our corporate that they both had already received this vaccine on 10/7/23. I informed the patients. They did not realize they had ever received it. They were not upset, and they were not experiencing any adverse reactions. They are doing well but know to follow up if anything changes.

December 10th: I began having left sided neck pain which progressed into left shoulder, chest and back pain over the next few days to the point I couldn?t sleep. December 14th: I called MD Live and completed a virtual visit for the left shoulder, arm, pectoral, and scapula pain. At that time I had full range of motion and no loss of strength in the left arm. I received and started a medrol dose pack that afternoon. I was taking Tylenol round the clock for pain with little relief and was also using Voltaren cream on the affected shoulder. The pain was excruciating and constant..December 16th: in the evening I began applying the Voltaren cream to my shoulder and felt what appeared to be a rash which covered my left shoulder, ran across the top of the left side of my back and down past my antecubital area on my left arm. I also began to lose muscle strength in my left arm and the pain extended into the left side of my face and external left ear. December 17th: I came to the office and saw Dr who confirmed the muscle weakness in the left arm and indicated the rash looked liked shingles. She sent me to the ER for further evaluation and MRI. The MRI confirmed Parsonage Turner syndrome. I was started on Acyclovir for the shingles, pain and sleeping meds. The rash subsided over the course of the next 2 weeks but the pain and weakness persisted. January 8: I saw the Neurologist and had a nerve conduction test performed which confirmed the upper brachial plexus was ?75%? gone but also indicated the nerves were already beginning to regenerate. She prescribed Amyltriptiline for the nerve pain and physical therapy. She recommended I return in 6 weeks. January 14: I began having some relief from the nerve pain January 20: Most of the pain has subsided, continue to have weakness but feel like I?m regaining some strength in the left arm.

Sweating, dry mouth within 1 hour of receiving vaccine. Patient went into hospital. Had chest congestion and required antibiotics. Had cough.

Injection Reaction. Started the same day. Large Bruise. As of 01/20/2025, bruise has not cleared.

HAD A SORE ARM FOR THE FIRST 3 DAYS. ON DAY 3 HE NOTICED A RASH ON HIS TORSO, WITH TINGLY HANDS AND A NUMB UPPER LIP. THE PATIENT ALSO HAD MILD CHEST PAIN AND AN INCREASED HEART RATE. TODAY IS DAY 6 AND HE SAYS THAT HE STILL HAS THE SYMPTOMS BUT THEY ARE MILDER THAN WHAT THEY WERE BEFORE.

My left upper arm swelled up terribly, bruised, and developed a very hard egg-size knot beside the injection site. Over the egg-size knot area, my skin was red & hot to touch. The circumference of the swelling initially was the size of a small grapefruit. I experienced & continue to experience severe pain and limited range of motion in my left arm. I keep icing the area and keeping an eye on the injury. I have never had a reaction like this before. It wasn’t due to my Pharmacy immunizing tech, he did a wonderful job.

Patient reported severe chills, severe diaphoresis, projectile vomiting, the evening of the vaccination day followed by extreme weakness lasting for 3 days. Patient did not notify us of these side effects until today (1/23/25) which was over 2 months past the date of vaccination.

None

Patient was due for Hep B but was given Hep A