Prolonged Pain After BNT Vaccination: A Patient's Journey

Discomfort after receiving the BNT vaccine?

Hello Dr.
Hong, I received my first dose of the BNT vaccine on June 20 at 15:58, and I began experiencing pain under my left clavicle at 16:08.
Twelve hours after the first dose, I developed a fever and redness and swelling at the injection site, which improved before I received my second dose (one week after the first dose).
During this time, I started exercising regularly for about 30 minutes each day, although I occasionally experienced pain under my left clavicle.
After receiving the second dose on July 21, I again experienced fever and other side effects, which completely resolved in about three days, but the pain under my left clavicle persisted.
I considered seeking local medical attention but decided to continue monitoring the situation.
On September 2, I visited a familiar clinic, and the doctor there recommended blood tests, so I was referred back to the family medicine department at a teaching hospital.
However, I am unsure if the doctor thought my post-vaccine discomfort was outside the scope of family medicine, as they referred me directly to the infectious disease department.
The infectious disease doctor conducted a simple blood test and X-ray, and everything seemed normal.
They suggested that I might be experiencing burnout.
Since I had a previous knee injury, I also visited the rehabilitation department that day.
The rehabilitation doctor recommended a cardiac evaluation and performed an echocardiogram to assess my muscles, which also showed no issues.
The cardiologist conducted blood tests and an echocardiogram, with all results appearing normal.
The echocardiogram did reveal mitral valve prolapse, which causes my heart rate to frequently increase (I once experienced a heart rate of 202 for no apparent reason).

However, none of these evaluations explained why I began experiencing pain under my left clavicle after vaccination, and the pain has increased since the end of September (it sometimes wakes me up at night or prevents me from sleeping).
I would like to know if the side effects of the BNT vaccine can last this long and if there is data indicating that clavicular pain is a side effect.
How can I improve this condition? Should I seek further medical attention (as I plan to study abroad at the end of the year)? What could be causing the increased pain? Additionally, I have received about eight vaccine doses within a year (including 5-6 doses of vaccines for studying abroad last year); could this be related? Is it safe for me to receive the flu vaccine next month?

Xiao Tian Shi, 10~19 year old female. Ask Date: 2021/10/05

Dr. Hong Yuanbin reply Internal Medicine

Hello, muscle and joint pain after vaccination is quite common.
However, if you have been experiencing pain for two months and it is getting worse, it may be necessary to consider that it might not be solely caused by the vaccine and that other underlying conditions could be involved.
The most common issues in the areas you described are muscle strains, followed by thoracic problems.
A detailed examination is required to determine the exact cause.
I recommend visiting an orthopedic or thoracic specialist at a medical center for a thorough evaluation.
Thank you for your inquiry.

Reply Date: 2021/10/05

More Info

It sounds like you've been through quite a journey since receiving your BNT vaccinations, and I appreciate your detailed account of your symptoms and the medical evaluations you've undergone. Let's break down your concerns regarding the prolonged pain under your left clavicle following your vaccinations, as well as address your questions about potential side effects and further medical action.

First, it's important to acknowledge that vaccine-related side effects can vary significantly from person to person. Common side effects of mRNA vaccines like BNT (Pfizer-BioNTech) typically include pain at the injection site, fatigue, headache, muscle pain, chills, fever, and joint pain. These symptoms usually resolve within a few days to a week. However, the persistence of pain, especially if it has been ongoing for several months, raises the possibility of other underlying issues that may not be directly related to the vaccine.

In your case, the left clavicle pain that began shortly after your first dose and has continued to persist, even increasing in intensity, warrants further investigation. While it's possible that the pain could be a residual effect of the vaccine, it is also crucial to consider other potential causes. These could include musculoskeletal issues, such as muscle strain or injury, particularly if you've been engaging in regular exercise. Additionally, conditions related to the thoracic region, such as costochondritis or even nerve-related issues, could be contributing factors.

The fact that you have undergone multiple evaluations, including blood tests, X-rays, and echocardiograms, is a positive step. These tests have indicated that there are no significant abnormalities, which is reassuring. However, given that your pain has not resolved and has even worsened, it may be beneficial to consult with a specialist, such as an orthopedic or thoracic surgeon, who can perform a more detailed assessment of your musculoskeletal system and potentially recommend imaging studies like an MRI if necessary.

Regarding your question about whether the BNT vaccine can cause prolonged side effects, while most side effects are transient, there have been rare reports of prolonged symptoms following vaccination. However, specific data on left clavicle pain as a side effect is limited. It's essential to remain vigilant and document any changes in your symptoms, as this information can be valuable for your healthcare provider.

As for your upcoming flu vaccination, it is generally safe to receive other vaccines after having received the COVID-19 vaccine, provided you are not experiencing acute illness or significant side effects from the previous vaccinations. However, given your ongoing symptoms, it may be wise to discuss this with your healthcare provider before proceeding.

In summary, while vaccine-related side effects are common and usually resolve quickly, your prolonged pain under the left clavicle should be further evaluated to rule out other potential causes. Consulting with a specialist may provide you with more clarity and a tailored treatment plan. Keep track of your symptoms and do not hesitate to seek medical attention, especially since you have plans to travel abroad for studies. Your health and well-being are paramount, and addressing these concerns proactively is the best approach.

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