Received Aug 27, 2025
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| HEPAB | HEP A + HEP B (TWINRIX) | GLAXOSMITHKLINE BIOLOGICALS | 1 | AZ2A3 | IM / LA |
| PNC21 | PNEUMO (CAPVAXIVE) | MERCK & CO. INC. | N/A | — | IM / RA |
| TDAP | TDAP (ADACEL) | SANOFI PASTEUR | N/A | 4CA04C1 | IM / LA |
| VARZOS | ZOSTER (SHINGRIX) | GLAXOSMITHKLINE BIOLOGICALS | 1 | 23AH3 | IM / RA |
| HEPAB | HEP A + HEP B (TWINRIX) | GLAXOSMITHKLINE BIOLOGICALS | UNK | AZ2A3 | SYR / AR |
| PNC15 | PNEUMO (VAXNEUVANCE) | MERCK & CO. INC. | UNK | 2003579 | SYR / AR |
| TDAP | TDAP (ADACEL) | SANOFI PASTEUR | UNK | 4CA04C1 | SYR / AR |
| VARZOS | ZOSTER (SHINGRIX) | GLAXOSMITHKLINE BIOLOGICALS | UNK | 23AH3 | SYR / AR |
Date of Vaccination: 08/18/2025 Vaccines Administered: Hepatitis A/B, Pneumococcal (PCV), Tdap, Herpes Zoster Pre-vaccination health: Patient reports being healthy and independent prior to immunizations. Timeline of Events ? Day 0 (08/18/25, evening): Within hours of vaccination, developed right arm/shoulder pain, head heaviness, dizziness. ? Day 1 (08/19/25): Woke with worsening body pain and acute neurological deficit affecting right side of face (facial droop, incomplete eye closure, difficulty eating, altered sensation). ? Day 2?3: Symptoms progressed with migratory pain, paresthesias, visual disturbance, and worsening shoulder pain. Sought outpatient care and was prescribed Prednisone and Valacyclovir. ? Day 3 (08/21/25, evening): Developed chest tightness, hypertensive crisis (BP 219/119), tachycardia, dizziness ? Emergency Room visit. CT scan and labs performed. Hospital observation overnight. Discharged with persistent neurological symptoms. ? Day 10 (08/27/25, present): Ongoing right facial paralysis, shoulder pain, sensory changes, vision sensitivity, difficulty eating and speaking, sleep disturbance, and reduced ability to perform daily activities. Clinical Impression ? Possible Brachial Neuritis / Cranial Neuropathy following Tdap vaccination (Onset within 1 day, ongoing deficits; fits within 2?28 day onset window listed on the Vaccine Injury Table). ? Shoulder Injury Related to Vaccine Administration (SIRVA): Severe persistent right shoulder pain beginning within 48 hours of injection. ? Neurological Injury (Bell?s palsy?like presentation / cranial neuropathy) temporally related to vaccines. ? Hypertensive crisis temporally related, likely stress response but contributed to ER admission. Functional Impact ? Right facial weakness: food falls from mouth, difficulty speaking clearly. ? Visual problems: incomplete eye closure, sensitivity to light, blurred vision. ? Musculoskeletal pain: limits use of right arm/shoulder. ? Psychological: anxiety, insomnia, mood changes. ? Safety/independence: cannot drive, requires assistance from spouse. Summary Patient was healthy prior to vaccination. Within 24 hours of receiving Tdap, Hep A/B, Pneumococcal, and Zoster vaccines simultaneously, developed neurological and musculoskeletal injuries consistent with Brachial Neuritis and/or SIRVA, both of which are recognized injuries under the Vaccine Injury Table. Symptoms remain disabling more than 10 days later, with ongoing need for neurological evaluation and treatment.
HIGH BLOOD PRESSURE, CHOLESTEROL
HIGH BLOOD PRESSURE, CHOLESTEROL
NONE
NONE
CBC WITH DIFFERENTIAL , COMPREHENSIVE METABOLIC PANEL, D DIMER, QUANTATIVE NT-PRO NATRIURETIC PEPTIDE, TROPONIN I HIGH SENSITIVE #1 AND #2 IMAGING: CT HEAD WITHOUT CONTRAST, CTA CHEST AORTA NON CORONARY, EKG 12-LEAD, X-RAY CHEST AP PORTABLE AND STILL FOLLOWING UP WITH ADDITIONAL EXAMS