Severe outbreak of gential herpes / outbreak was very mild / immediately followed by another severe outbreak; Health has plummeted and the quality of life is dramatically reduced; Pain in my buttocks; Pain in Hamstring; Lower back pain / back pain; Calves pain; Discomfort; Pain in eardrums / pain in my ears; Ringing in my ears; Pain on the sides of my head / he has so much pain on the unaffected side of his head / frequent headaches now; Pain in my eyes; Pinching of my skin / pinching on my torso / pinching in my legs; Pain on my torso; Pains throughout my body especially at the site of old injuries; Neck pain; Pain in the bottoms of his feet; Pain in the palms of his hands / Odd pains in his forearms; Unable to work out; With odd and scary feelings in my muscles; Often nauseas now; Miserable symptoms / terrifying symptoms; Tried a workout two days ago and it has resulted in a worsening of symptoms; This spontaneous case, initially received on 17-Jan-2025, was reported by a non health professional and concerns an adult male patient. Past medical history included genital herpes, Ramsay Hunt Syndrome, Some autoimmune dysfunction. No concomitant medications were reported Administration of company suspect drug: On 17-Nov-2024, the patient received Afluria (TIV) for influenza immunization, dose regimen, route of administration and anatomical location: not reported, Lot number: not reported but will be requested upon follow-up. No additional suspect drugs. Adverse reactions/events and outcomes: On 19-Nov-2024, 2 days after vaccination, the patient experienced Severe outbreak of gential herpes / outbreak was very mild / immediately followed by another severe outbreak (outcome: Unknown), Health has plummeted and the quality of life is dramatically reduced (outcome: Unknown), Pain in my buttocks (outcome: Unknown), Pain in Hamstring (outcome: Unknown), Lower back pain / back pain (outcome: Unknown), Calves pain (outcome: Unknown), Discomfort (outcome: Unknown), Pain in eardrums / pain in my ears (outcome: Unknown), Ringing in my ears (outcome: Unknown), Pain on the sides of my head / he has so much pain on the unaffected side of his head / frequent headaches now (outcome: Unknown), Pain in my eyes (outcome: Unknown), Pinching of my skin / pinching on my torso / pinching in my legs (outcome: Unknown), Pain on my torso (outcome: Unknown), Pains throughout my body especially at the site of old injuries (outcome: Unknown), Neck pain (outcome: Unknown), Pain in the bottoms of his feet (outcome: Unknown), Pain in the palms of his hands / Odd pains in his forearms (outcome: Unknown), Unable to work out (outcome: Unknown), With odd and scary feelings in my muscles (outcome: Unknown), Often nauseas now (outcome: Unknown), Miserable symptoms / terrifying symptoms (outcome: Unknown), Tried a workout two days ago and it has resulted in a worsening of symptoms. On 17-Nov-2024 patient was vaccinated with the Afluria 24-25 TIV LA/RA flu vaccine. Prior to being vaccinated he was in excellent health. Since the vaccine, his health has plummeted, and the quality of my life was dramatically reduced. When he said “excellent health” he was not exaggerating. He was routinely hiking ten miles with dogs, strenuously working out, working hard around property and much more physically fit than most 30-year-olds but he was older than that. Two days after being vaccinated he had a severe outbreak of genital herpes, which he had not occurrences of for at least three years prior and at that time (three years prior), the outbreak was very mild. He had not for many years had any significant genital herpes outbreaks. The outbreak which started on 19-Nov-2024 was immediately followed by another severe outbreak, as this subsided, it was followed by yet another outbreak and then another outbreak after that. He now had pain in his buttocks, hamstrings, lower back and calves which come along with herpes outbreaks. In addition to the extreme discomfort this had had a devastating effect on my relationship with my partner. He had shingles as Ramsay Hunt Syndrome in 2019 which had been in remission but following the vaccination on 17-Nov-2024 now had the symptoms of that again. This included pain in eardrums, pain in ears, ringing in ears, pain on the sides of head, pain in eyes, pinching of skin, pain on torso, pinching on torso, pinching in legs. It was extremely disturbing that he had so much pain on the unaffected side of his head and he was very concerned that would be stricken with Ramsay Hunt on that side, which would destroy his health. Additionally he had some autoimmune dysfunction in the mid 2000s, which was of unknown origin and which spent a lot of money and time to lift himself out of with rest, careful diet and exercise and medication. He had been symptom free of that since about 2012 and stopped taking any medication for those symptoms in about 2017, but now the symptoms of that had returned. He had pains throughout his body, especially at the site of old injuries. He had neck pain, back pain, pain in the bottoms of his feet, pain in the palms of his hands, odd pains in his forearms. He had frequent headaches now, and he almost never have had headaches in his life. Prior to 17-Nov-2024, when received the Afluria vaccination, he was extremely physically fit. He worked out twice each week in the gym, doing very strenuous workouts and rarely missing that exercise. He performed three sets of ten pullups, five sets of squats, hip thrusts, leg curls, calf raises, barbell rowing on one day and bench presses, shoulder presses, bar dips, planks, upright rows, dumbell raises on the other day. Now, exactly two months later, he was unable to work out. He tried a workout two days before and it had resulted in a worsening of symptoms. The normal post exercise pain that one might experience after a workout was replaced with odd and scary feelings in his muscles. He had to visit health care provider for additional anti-virals to try to keep these herpes infections at bay and he was forced to take double and triple the dosage. He had often nauseas now and did not know if it was a side effect from all the anti-virals or a side effect of the Afluria vaccination. He was an adult and recently started a new job which was critical for his family’s wellbeing. The job required travel, which had had to do with the miserable symptoms. He had to put on a happy face in meetings while experience these pains and other terrifying symptoms Afluria (TIV) action taken: Not Applicable Reporter assessment: the reporter did not provide a seriousness and causality assessment for the events.; Reporter’s Comments: Causality: Related for all the events. Due to the spontaneous nature of the case, it is considered related for the reporting purpose. Close temporal relationship, onset after 2 days after vaccination. However, medical histories could be a possible risk factors for the events to occur.