Received May 14, 2025
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| HPV9 | HPV (GARDASIL 9) | MERCK & CO. INC. | 2 | 2014790 | IM / RA |
| MENB | MENINGOCOCCAL B (BEXSERO) | NOVARTIS VACCINES AND DIAGNOSTICS | 1 | 77KA5 | IM / LA |
Hello, (Email from on 05/13/25) Just some questions on patient (Questions and answers from PA-C who emailed back.) 1. Could you see the actual injection site? If so, was placement correct? Yes, on my physical exam on 5/12/25 I could see where she received the injection as there was a small puncture mark still visible on her left lateral deltoid and that was the point of maximum tenderness. 2. What did the actual injection site look like? Besides the small puncture mark, there was no other visible abnormalities of the injection site (ie. No swelling, bruising, redness) 3. Pt was seen for shoulder/body injury on the 7th, seen at facility on the 8th for neck pain, then another facility on the 11th for shoulder pain, and then another facility on the 12th for left arm pain. All re: shoulder, neck, upper back pain. Adverse effect of vaccine??? Recommend not getting the MenB #2 of 2??? Per patient history she was knocked over by a friend on 5/7/25 which caused her to fall and hit her upper back/neck which she was evaluated for on 5/8/25. She did not complain of any shoulder or arm pain at that time. She received 2 immunizations, MEN B in the left deltoid and HPV dose #2 in the right deltoid, at the 5/8/25 OV. Patient reported some injection site tenderness of Left shoulder on Friday 5/9/25 to her parent and they decided to monitor. Patient reported that pain turned into numbness/tingling of her left arm as the day progressed on Friday, then it worsened on Saturday where she could barely move her left arm, so then parent took her to facility on 5/11/25 for evaluation. Patient stated they did not give her any clear answers and said she may have torn a muscle in her arm and told her to take OTC acetaminophen and ibuprofen as needed. Patient seen on 5/12/25 for worsening left arm pain/tingling and upon further history and progression of symptoms it was determined that symptoms were highly likely related to MEN B immunization on 5/8/25 as that was the immunization given in that arm. Patient denied doing any activity that would have injured her left arm or caused her to tear a muscle. Physical exam did not align with impingement syndrome from previous neck pain complaint and with maximum tenderness still at the injection site this provider determined this likely was a vaccine adverse effect. Patient had limited range of motion of left arm and pain with movement, facility gave her an arm sling to wear due to symptoms. Patient still wore arm sling on 5/12/25 and unable to move arm actively or passively without moderate pain. Per progression and severity of symptoms this provider recommended that patient not get MEN B dose #2. I?m just making sure before I complete this VEARS Report and put an alert in the chart. Thanks.
Shoulder, upper back, & neck pain from a larger playmate that landed on her when she was already down on the ground.
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NKA
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