Received Jul 18, 2025
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| VARZOS | ZOSTER (SHINGRIX) | GLAXOSMITHKLINE BIOLOGICALS | 1 | 9L944 | IM / LA |
Pt reported having pain in arm approximately 3 days after injection. He had gone to PCP, who did an X-ray and didn't find anything wrong, and so pt went home. A few days later pt had more severe pain under the armpit down to elbow, and noticed a knot under the arm. He ended up going to the ER to rule out a heart attack since it was his left arm, which concerned him. They did a CT scan and after some discussion with pt, in regards to type of pain, onset of pain, and fact that pt had recently had a vaccine, that it was likely a case of Sirva. Pt has extremely double jointed shoulders that he has been able to pull in and out of socket easily over the years. He has had surgery on the right should to help correct this, but not the left one. The ER doctor thinks that when pt relaxed his shoulder prior to injection, it may have shifted his joint down lower than what would be normal and expected, which could have resulted in IMZ going into the joint or bursa. Even though dose was given correctly in what appeared to be pt's deltoid area, due to his unusual anatomy, (which the doctor indicated he had a longer than normal structure in his shoulder, but the pt couldn't recall exactly what part), the injection did not end up just in his deltoid muscle. Pt left the ER after confirming his heart was ok. The pain subsided over the next 6 weeks or so, and is currently minimal. Pt did not seek any other treatment other than putting ice on it from home. Pt did not feel like this was due to negligence on the administration of the IMZ, but just a fluke incident due to his non-traditional shoulder anatomy.
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omeprazole 20mg, alprazolam 5mg, Linzess 145mcg
prednisone and NSAIDS
x-ray and CT scan