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This is VAERS ID 264024

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History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 264024
VAERS Form:
Age:
Sex:Male
Location:New York
Vaccinated:2006-09-08
Onset:2006-09-09
Submitted:2006-10-02
Entered:2006-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER VACCINE LIVE (OKA/MERCK) (ZOSTAVAX) / MERCK & CO. INC. - / - UN / -

Administered by: Other      Purchased by: Unknown
Symptoms: Herpes zoster, Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Information has been received from a physician concerning a male pt who on 9/9/06 was vaccianted with a dose of varicella zoster virus vaccine live. On 9/8/06 the pt was hospitalized with a rash. The was diagnosed with a zoster infection. No outcome was r"eported. No product quality complaint was involved. Additional information has been requested.


Changed on 12/8/2009

VAERS ID: 264024 Before After
VAERS Form:
Age:
Sex:Male
Location:New York
Vaccinated:2006-09-08
Onset:2006-09-09
Submitted:2006-10-02
Entered:2006-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER VACCINE LIVE (OKA/MERCK) (ZOSTAVAX) ZOSTER (ZOSTAVAX) / MERCK & CO. INC. - / - UN / -

Administered by: Other      Purchased by: Unknown Other
Symptoms: Herpes zoster, Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) WAES0609USA06560

Write-up: Information has been received from a physician concerning a male pt who on 9/9/06 was vaccianted with a dose of varicella zoster virus vaccine live. On 9/8/06 the pt was hospitalized with a rash. The was diagnosed with a zoster infection. No outcome was r"eported. reported. No product quality complaint was involved. Additional information has been requested.


Changed on 9/14/2017

VAERS ID: 264024 Before After
VAERS Form:(blank) 1
Age:
Sex:Male
Location:New York
Vaccinated:2006-09-08
Onset:2006-09-09
Submitted:2006-10-02
Entered:2006-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER (ZOSTAVAX) / MERCK & CO. INC. - / - UNK UN / -

Administered by: Other      Purchased by: Other
Symptoms: Herpes zoster, Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0609USA06560

Write-up: Information has been received from a physician concerning a male pt who on 9/9/06 was vaccianted with a dose of varicella zoster virus vaccine live. On 9/8/06 the pt was hospitalized with a rash. The was diagnosed with a zoster infection. No outcome was reported. No product quality complaint was involved. Additional information has been requested.


Changed on 2/14/2018

VAERS ID: 264024 Before After
VAERS Form:1
Age:
Sex:Male
Location:New York
Vaccinated:2006-09-08
Onset:2006-09-09
Submitted:2006-10-02
Entered:2006-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER (ZOSTAVAX) / MERCK & CO. INC. - / UNK UN / -

Administered by: Other      Purchased by: Other
Symptoms: Herpes zoster, Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0609USA06560

Write-up: Information has been received from a physician concerning a male pt who on 9/9/06 was vaccianted with a dose of varicella zoster virus vaccine live. On 9/8/06 the pt was hospitalized with a rash. The was diagnosed with a zoster infection. No outcome was reported. No product quality complaint was involved. Additional information has been requested.


Changed on 6/14/2018

VAERS ID: 264024 Before After
VAERS Form:1
Age:
Sex:Male
Location:New York
Vaccinated:2006-09-08
Onset:2006-09-09
Submitted:2006-10-02
Entered:2006-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER (ZOSTAVAX) / MERCK & CO. INC. - / UNK UN / -

Administered by: Other      Purchased by: Other
Symptoms: Herpes zoster, Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0609USA06560

Write-up: Information has been received from a physician concerning a male pt who on 9/9/06 was vaccianted with a dose of varicella zoster virus vaccine live. On 9/8/06 the pt was hospitalized with a rash. The was diagnosed with a zoster infection. No outcome was reported. No product quality complaint was involved. Additional information has been requested.


Changed on 8/14/2018

VAERS ID: 264024 Before After
VAERS Form:1
Age:
Sex:Male
Location:New York
Vaccinated:2006-09-08
Onset:2006-09-09
Submitted:2006-10-02
Entered:2006-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER (ZOSTAVAX) / MERCK & CO. INC. - / UNK UN / -

Administered by: Other      Purchased by: Other
Symptoms: Herpes zoster, Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0609USA06560

Write-up: Information has been received from a physician concerning a male pt who on 9/9/06 was vaccianted with a dose of varicella zoster virus vaccine live. On 9/8/06 the pt was hospitalized with a rash. The was diagnosed with a zoster infection. No outcome was reported. No product quality complaint was involved. Additional information has been requested.


Changed on 9/14/2018

VAERS ID: 264024 Before After
VAERS Form:1
Age:
Sex:Male
Location:New York
Vaccinated:2006-09-08
Onset:2006-09-09
Submitted:2006-10-02
Entered:2006-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER (ZOSTAVAX) / MERCK & CO. INC. - / UNK UN / -

Administered by: Other      Purchased by: Other
Symptoms: Herpes zoster, Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0609USA06560

Write-up: Information has been received from a physician concerning a male pt who on 9/9/06 was vaccianted with a dose of varicella zoster virus vaccine live. On 9/8/06 the pt was hospitalized with a rash. The was diagnosed with a zoster infection. No outcome was reported. No product quality complaint was involved. Additional information has been requested.


Changed on 10/14/2018

VAERS ID: 264024 Before After
VAERS Form:1
Age:
Sex:Male
Location:New York
Vaccinated:2006-09-08
Onset:2006-09-09
Submitted:2006-10-02
Entered:2006-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER (ZOSTAVAX) / MERCK & CO. INC. - / UNK UN / -

Administered by: Other      Purchased by: Other
Symptoms: Herpes zoster, Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0609USA06560

Write-up: Information has been received from a physician concerning a male pt who on 9/9/06 was vaccianted with a dose of varicella zoster virus vaccine live. On 9/8/06 the pt was hospitalized with a rash. The was diagnosed with a zoster infection. No outcome was reported. No product quality complaint was involved. Additional information has been requested.


Changed on 8/14/2019

VAERS ID: 264024 Before After
VAERS Form:1
Age:
Sex:Male
Location:New York
Vaccinated:2006-09-08
Onset:2006-09-09
Submitted:2006-10-02
Entered:2006-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER (ZOSTAVAX) ZOSTER LIVE (ZOSTAVAX) / MERCK & CO. INC. - / UNK UN / -

Administered by: Other      Purchased by: Other
Symptoms: Herpes zoster, Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0609USA06560

Write-up: Information has been received from a physician concerning a male pt who on 9/9/06 was vaccianted with a dose of varicella zoster virus vaccine live. On 9/8/06 the pt was hospitalized with a rash. The was diagnosed with a zoster infection. No outcome was reported. No product quality complaint was involved. Additional information has been requested.


Changed on 12/24/2020

VAERS ID: 264024 Before After
VAERS Form:1
Age:
Sex:Male
Location:New York
Vaccinated:2006-09-08
Onset:2006-09-09
Submitted:2006-10-02
Entered:2006-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER LIVE (ZOSTAVAX) / MERCK & CO. INC. - / UNK UN / -

Administered by: Other      Purchased by: Other
Symptoms: Herpes zoster, Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0609USA06560

Write-up: Information has been received from a physician concerning a male pt who on 9/9/06 was vaccianted with a dose of varicella zoster virus vaccine live. On 9/8/06 the pt was hospitalized with a rash. The was diagnosed with a zoster infection. No outcome was reported. No product quality complaint was involved. Additional information has been requested.


Changed on 12/30/2020

VAERS ID: 264024 Before After
VAERS Form:1
Age:
Sex:Male
Location:New York
Vaccinated:2006-09-08
Onset:2006-09-09
Submitted:2006-10-02
Entered:2006-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER LIVE (ZOSTAVAX) / MERCK & CO. INC. - / UNK UN / -

Administered by: Other      Purchased by: Other
Symptoms: Herpes zoster, Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0609USA06560

Write-up: Information has been received from a physician concerning a male pt who on 9/9/06 was vaccianted with a dose of varicella zoster virus vaccine live. On 9/8/06 the pt was hospitalized with a rash. The was diagnosed with a zoster infection. No outcome was reported. No product quality complaint was involved. Additional information has been requested.


Changed on 5/7/2021

VAERS ID: 264024 Before After
VAERS Form:1
Age:
Sex:Male
Location:New York
Vaccinated:2006-09-08
Onset:2006-09-09
Submitted:2006-10-02
Entered:2006-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER LIVE (ZOSTAVAX) / MERCK & CO. INC. - / UNK UN / -

Administered by: Other      Purchased by: Other
Symptoms: Herpes zoster, Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0609USA06560

Write-up: Information has been received from a physician concerning a male pt who on 9/9/06 was vaccianted with a dose of varicella zoster virus vaccine live. On 9/8/06 the pt was hospitalized with a rash. The was diagnosed with a zoster infection. No outcome was reported. No product quality complaint was involved. Additional information has been requested.


Changed on 5/21/2021

VAERS ID: 264024 Before After
VAERS Form:1
Age:
Sex:Male
Location:New York
Vaccinated:2006-09-08
Onset:2006-09-09
Submitted:2006-10-02
Entered:2006-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER LIVE (ZOSTAVAX) / MERCK & CO. INC. - / UNK UN / -

Administered by: Other      Purchased by: Other
Symptoms: Herpes zoster, Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0609USA06560

Write-up: Information has been received from a physician concerning a male pt who on 9/9/06 was vaccianted with a dose of varicella zoster virus vaccine live. On 9/8/06 the pt was hospitalized with a rash. The was diagnosed with a zoster infection. No outcome was reported. No product quality complaint was involved. Additional information has been requested.

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