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This is VAERS ID 265040

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History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 265040
VAERS Form:
Age:74.0
Sex:Male
Location:Missouri
Vaccinated:2006-10-11
Onset:2006-10-18
Submitted:2006-10-20
Entered:2006-10-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (FLUVIRIN) / CHIRON CORPORATION 70089 / 0 RA / IM
VARZOS: ZOSTER VACCINE LIVE (OKA/MERCK) (ZOSTAVAX) / MERCK & CO. INC. 0981F / 0 LA / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Anaemia, Dehydration, Hydronephrosis, Prostatic disorder, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: hyoscymine, metamucil, vitamins, Flomax, Vitamin D. Started Bactrim on day of vaccinations.
Current Illness: superficial wound infection with B. fragilis.
Preexisting Conditions: allergy-phenergan history of colectomy for ulcerative colitis, osteoporosis, vitamin D deficiency
Allergies:
Diagnostic Lab Data: CBC no shift, CXR, Urine culture, blood cultures negative.
CDC 'Split Type':

Write-up: Received Zostavax and flu vaccine on 10/11. Developed fever 102.4 documented on 10/18. Was admitted for IV fluids. No other obvious source found. Had recently been hospitalized and operated for small obstruction which made him susceptible to the dehyd"ration factor. No infectious etiology found related to fever.


Changed on 12/8/2009

VAERS ID: 265040 Before After
VAERS Form:
Age:74.0
Sex:Male
Location:Missouri
Vaccinated:2006-10-11
Onset:2006-10-18
Submitted:2006-10-20
Entered:2006-10-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (FLUVIRIN) INFLUENZA (SEASONAL) (FLUVIRIN) / CHIRON CORPORATION 70089 / 0 RA / IM
VARZOS: ZOSTER VACCINE LIVE (OKA/MERCK) (ZOSTAVAX) ZOSTER (ZOSTAVAX) / MERCK & CO. INC. 0981F / 0 LA / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Anaemia, Dehydration, Hydronephrosis, Prostatic disorder, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: hyoscymine, Meds: metamucil, Ergocalciferol, Flomax, Lidocaine/Prilocaine topical, Hyoscyamine sulfate PRN, vitamins, Flomax, Vitamin D. Started Bactrim on day of vaccinations. D, and sulfamethoxazole-trimethoprim.
Current Illness: superficial wound infection with B. fragilis.
Preexisting Conditions: allergy-phenergan history of colectomy for ulcerative colitis, osteoporosis, vitamin D deficiency PMH: COPD, Hypertension, Hemorrhoids, Joint pain, Sleep Apnea, cataracts, osteoporosis, diverticuli, low back pain, anemia, sinusitis, allergic rhinitis and testosterone deficiency. Recent surgery for bowel obstruction with wound dehiscence.
Allergies:
Diagnostic Lab Data: CBC no shift, CXR, Urine culture, blood cultures negative. LABS and DIAGNOSTICS: Renal US shows mild left hydronephrosis and moderate postvoid residual.
CDC 'Split Type':

Write-up: Received Zostavax and flu vaccine on 10/11. Developed fever 102.4 documented on 10/18. Was admitted for IV fluids. No other obvious source found. Had recently been hospitalized and operated for small obstruction which made him susceptible to the dehyd"ration dehydration factor. No infectious etiology found related to fever. Hospital and PCP MRs received documenting 73 yr old who presents 1 week s/p Flu and Zostavx immunizations with fever, dysuria, and not feeling well. Patient reports need to push on bladder to empty. Admitted to hospital for hydration and IV antibiotics. Impression: "Suspect UTI from inability to empty bladder well. Doubt reaction to Zostavax" Discharge DX: Fever, Dehydration, Hydronephrosis, BPH with outlet obstruction, concha bullosa, anemia, and past hx. of abd. incision dehiscence.


Changed on 7/7/2013

VAERS ID: 265040 Before After
VAERS Form:
Age:74.0
Sex:Male
Location:Missouri
Vaccinated:2006-10-11
Onset:2006-10-18
Submitted:2006-10-20
Entered:2006-10-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUVIRIN) / CHIRON CORPORATION 70089 / 0 RA / IM
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / CHIRON CORPORATION 70089 / 0 RA / IM
VARZOS: ZOSTER (ZOSTAVAX) / MERCK & CO. INC. 0981F / 0 LA / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Anaemia, Dehydration, Hydronephrosis, Prostatic disorder, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Meds: metamucil, Ergocalciferol, Flomax, Lidocaine/Prilocaine topical, Hyoscyamine sulfate PRN, vitamins, Vitamin D, and sulfamethoxazole-trimethoprim.
Current Illness: superficial wound infection with B. fragilis.
Preexisting Conditions: allergy-phenergan history of colectomy for ulcerative colitis, osteoporosis, vitamin D deficiency PMH: COPD, Hypertension, Hemorrhoids, Joint pain, Sleep Apnea, cataracts, osteoporosis, diverticuli, low back pain, anemia, sinusitis, allergic rhinitis and testosterone deficiency. Recent surgery for bowel obstruction with wound dehiscence.
Allergies:
Diagnostic Lab Data: CBC no shift, CXR, Urine culture, blood cultures negative. LABS and DIAGNOSTICS: Renal US shows mild left hydronephrosis and moderate postvoid residual.
CDC 'Split Type':

Write-up: Received Zostavax and flu vaccine on 10/11. Developed fever 102.4 documented on 10/18. Was admitted for IV fluids. No other obvious source found. Had recently been hospitalized and operated for small obstruction which made him susceptible to the dehydration factor. No infectious etiology found related to fever. Hospital and PCP MRs received documenting 73 yr old who presents 1 week s/p Flu and Zostavx immunizations with fever, dysuria, and not feeling well. Patient reports need to push on bladder to empty. Admitted to hospital for hydration and IV antibiotics. Impression: "Suspect UTI from inability to empty bladder well. Doubt reaction to Zostavax" Discharge DX: Fever, Dehydration, Hydronephrosis, BPH with outlet obstruction, concha bullosa, anemia, and past hx. of abd. incision dehiscence.


Changed on 2/14/2017

VAERS ID: 265040 Before After
VAERS Form:
Age:74.0
Sex:Male
Location:Missouri
Vaccinated:2006-10-11
Onset:2006-10-18
Submitted:2006-10-20
Entered:2006-10-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / CHIRON CORPORATION NOVARTIS VACCINES AND DIAGNOSTICS 70089 / 0 RA / IM
VARZOS: ZOSTER (ZOSTAVAX) / MERCK & CO. INC. 0981F / 0 LA / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Anaemia, Dehydration, Hydronephrosis, Prostatic disorder, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Meds: metamucil, Ergocalciferol, Flomax, Lidocaine/Prilocaine topical, Hyoscyamine sulfate PRN, vitamins, Vitamin D, and sulfamethoxazole-trimethoprim.
Current Illness: superficial wound infection with B. fragilis.
Preexisting Conditions: allergy-phenergan history of colectomy for ulcerative colitis, osteoporosis, vitamin D deficiency PMH: COPD, Hypertension, Hemorrhoids, Joint pain, Sleep Apnea, cataracts, osteoporosis, diverticuli, low back pain, anemia, sinusitis, allergic rhinitis and testosterone deficiency. Recent surgery for bowel obstruction with wound dehiscence.
Allergies:
Diagnostic Lab Data: CBC no shift, CXR, Urine culture, blood cultures negative. LABS and DIAGNOSTICS: Renal US shows mild left hydronephrosis and moderate postvoid residual.
CDC 'Split Type':

Write-up: Received Zostavax and flu vaccine on 10/11. Developed fever 102.4 documented on 10/18. Was admitted for IV fluids. No other obvious source found. Had recently been hospitalized and operated for small obstruction which made him susceptible to the dehydration factor. No infectious etiology found related to fever. Hospital and PCP MRs received documenting 73 yr old who presents 1 week s/p Flu and Zostavx immunizations with fever, dysuria, and not feeling well. Patient reports need to push on bladder to empty. Admitted to hospital for hydration and IV antibiotics. Impression: "Suspect UTI from inability to empty bladder well. Doubt reaction to Zostavax" Discharge DX: Fever, Dehydration, Hydronephrosis, BPH with outlet obstruction, concha bullosa, anemia, and past hx. of abd. incision dehiscence.


Changed on 9/14/2017

VAERS ID: 265040 Before After
VAERS Form:(blank) 1
Age:74.0
Sex:Male
Location:Missouri
Vaccinated:2006-10-11
Onset:2006-10-18
Submitted:2006-10-20
Entered:2006-10-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / NOVARTIS VACCINES AND DIAGNOSTICS 70089 / 0 1 RA / IM
VARZOS: ZOSTER (ZOSTAVAX) / MERCK & CO. INC. 0981F / 0 1 LA / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Anaemia, Dehydration, Hydronephrosis, Prostatic disorder, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Meds: metamucil, Ergocalciferol, Flomax, Lidocaine/Prilocaine topical, Hyoscyamine sulfate PRN, vitamins, Vitamin D, and sulfamethoxazole-trimethoprim.
Current Illness: superficial wound infection with B. fragilis.
Preexisting Conditions: allergy-phenergan history of colectomy for ulcerative colitis, osteoporosis, vitamin D deficiency PMH: COPD, Hypertension, Hemorrhoids, Joint pain, Sleep Apnea, cataracts, osteoporosis, diverticuli, low back pain, anemia, sinusitis, allergic rhinitis and testosterone deficiency. Recent surgery for bowel obstruction with wound dehiscence.
Allergies:
Diagnostic Lab Data: CBC no shift, CXR, Urine culture, blood cultures negative. LABS and DIAGNOSTICS: Renal US shows mild left hydronephrosis and moderate postvoid residual.
CDC 'Split Type':

Write-up: Received Zostavax and flu vaccine on 10/11. Developed fever 102.4 documented on 10/18. Was admitted for IV fluids. No other obvious source found. Had recently been hospitalized and operated for small obstruction which made him susceptible to the dehydration factor. No infectious etiology found related to fever. Hospital and PCP MRs received documenting 73 yr old who presents 1 week s/p Flu and Zostavx immunizations with fever, dysuria, and not feeling well. Patient reports need to push on bladder to empty. Admitted to hospital for hydration and IV antibiotics. Impression: "Suspect UTI from inability to empty bladder well. Doubt reaction to Zostavax" Discharge DX: Fever, Dehydration, Hydronephrosis, BPH with outlet obstruction, concha bullosa, anemia, and past hx. of abd. incision dehiscence.


Changed on 2/14/2018

VAERS ID: 265040 Before After
VAERS Form:1
Age:74.0
Sex:Male
Location:Missouri
Vaccinated:2006-10-11
Onset:2006-10-18
Submitted:2006-10-20
Entered:2006-10-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / NOVARTIS VACCINES AND DIAGNOSTICS 70089 / 1 RA / IM
VARZOS: ZOSTER (ZOSTAVAX) / MERCK & CO. INC. 0981F / 1 LA / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Anaemia, Dehydration, Hydronephrosis, Prostatic disorder, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Meds: metamucil, Ergocalciferol, Flomax, Lidocaine/Prilocaine topical, Hyoscyamine sulfate PRN, vitamins, Vitamin D, and sulfamethoxazole-trimethoprim.
Current Illness: superficial wound infection with B. fragilis.
Preexisting Conditions: allergy-phenergan history of colectomy for ulcerative colitis, osteoporosis, vitamin D deficiency PMH: COPD, Hypertension, Hemorrhoids, Joint pain, Sleep Apnea, cataracts, osteoporosis, diverticuli, low back pain, anemia, sinusitis, allergic rhinitis and testosterone deficiency. Recent surgery for bowel obstruction with wound dehiscence.
Allergies:
Diagnostic Lab Data: CBC no shift, CXR, Urine culture, blood cultures negative. LABS and DIAGNOSTICS: Renal US shows mild left hydronephrosis and moderate postvoid residual.
CDC 'Split Type':

Write-up: Received Zostavax and flu vaccine on 10/11. Developed fever 102.4 documented on 10/18. Was admitted for IV fluids. No other obvious source found. Had recently been hospitalized and operated for small obstruction which made him susceptible to the dehydration factor. No infectious etiology found related to fever. Hospital and PCP MRs received documenting 73 yr old who presents 1 week s/p Flu and Zostavx immunizations with fever, dysuria, and not feeling well. Patient reports need to push on bladder to empty. Admitted to hospital for hydration and IV antibiotics. Impression: "Suspect UTI from inability to empty bladder well. Doubt reaction to Zostavax" Discharge DX: Fever, Dehydration, Hydronephrosis, BPH with outlet obstruction, concha bullosa, anemia, and past hx. of abd. incision dehiscence.


Changed on 6/14/2018

VAERS ID: 265040 Before After
VAERS Form:1
Age:74.0
Sex:Male
Location:Missouri
Vaccinated:2006-10-11
Onset:2006-10-18
Submitted:2006-10-20
Entered:2006-10-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / NOVARTIS VACCINES AND DIAGNOSTICS 70089 / 1 RA / IM
VARZOS: ZOSTER (ZOSTAVAX) / MERCK & CO. INC. 0981F / 1 LA / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Anaemia, Dehydration, Hydronephrosis, Prostatic disorder, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Meds: metamucil, Ergocalciferol, Flomax, Lidocaine/Prilocaine topical, Hyoscyamine sulfate PRN, vitamins, Vitamin D, and sulfamethoxazole-trimethoprim.
Current Illness: superficial wound infection with B. fragilis.
Preexisting Conditions: allergy-phenergan history of colectomy for ulcerative colitis, osteoporosis, vitamin D deficiency PMH: COPD, Hypertension, Hemorrhoids, Joint pain, Sleep Apnea, cataracts, osteoporosis, diverticuli, low back pain, anemia, sinusitis, allergic rhinitis and testosterone deficiency. Recent surgery for bowel obstruction with wound dehiscence.
Allergies:
Diagnostic Lab Data: CBC no shift, CXR, Urine culture, blood cultures negative. LABS and DIAGNOSTICS: Renal US shows mild left hydronephrosis and moderate postvoid residual.
CDC 'Split Type':

Write-up: Received Zostavax and flu vaccine on 10/11. Developed fever 102.4 documented on 10/18. Was admitted for IV fluids. No other obvious source found. Had recently been hospitalized and operated for small obstruction which made him susceptible to the dehydration factor. No infectious etiology found related to fever. Hospital and PCP MRs received documenting 73 yr old who presents 1 week s/p Flu and Zostavx immunizations with fever, dysuria, and not feeling well. Patient reports need to push on bladder to empty. Admitted to hospital for hydration and IV antibiotics. Impression: "Suspect UTI from inability to empty bladder well. Doubt reaction to Zostavax" Discharge DX: Fever, Dehydration, Hydronephrosis, BPH with outlet obstruction, concha bullosa, anemia, and past hx. of abd. incision dehiscence.


Changed on 8/14/2018

VAERS ID: 265040 Before After
VAERS Form:1
Age:74.0
Sex:Male
Location:Missouri
Vaccinated:2006-10-11
Onset:2006-10-18
Submitted:2006-10-20
Entered:2006-10-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / NOVARTIS VACCINES AND DIAGNOSTICS 70089 / 1 RA / IM
VARZOS: ZOSTER (ZOSTAVAX) / MERCK & CO. INC. 0981F / 1 LA / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Anaemia, Dehydration, Hydronephrosis, Prostatic disorder, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Meds: metamucil, Ergocalciferol, Flomax, Lidocaine/Prilocaine topical, Hyoscyamine sulfate PRN, vitamins, Vitamin D, and sulfamethoxazole-trimethoprim.
Current Illness: superficial wound infection with B. fragilis.
Preexisting Conditions: allergy-phenergan history of colectomy for ulcerative colitis, osteoporosis, vitamin D deficiency PMH: COPD, Hypertension, Hemorrhoids, Joint pain, Sleep Apnea, cataracts, osteoporosis, diverticuli, low back pain, anemia, sinusitis, allergic rhinitis and testosterone deficiency. Recent surgery for bowel obstruction with wound dehiscence.
Allergies:
Diagnostic Lab Data: CBC no shift, CXR, Urine culture, blood cultures negative. LABS and DIAGNOSTICS: Renal US shows mild left hydronephrosis and moderate postvoid residual.
CDC 'Split Type':

Write-up: Received Zostavax and flu vaccine on 10/11. Developed fever 102.4 documented on 10/18. Was admitted for IV fluids. No other obvious source found. Had recently been hospitalized and operated for small obstruction which made him susceptible to the dehydration factor. No infectious etiology found related to fever. Hospital and PCP MRs received documenting 73 yr old who presents 1 week s/p Flu and Zostavx immunizations with fever, dysuria, and not feeling well. Patient reports need to push on bladder to empty. Admitted to hospital for hydration and IV antibiotics. Impression: "Suspect UTI from inability to empty bladder well. Doubt reaction to Zostavax" Discharge DX: Fever, Dehydration, Hydronephrosis, BPH with outlet obstruction, concha bullosa, anemia, and past hx. of abd. incision dehiscence.


Changed on 9/14/2018

VAERS ID: 265040 Before After
VAERS Form:1
Age:74.0
Sex:Male
Location:Missouri
Vaccinated:2006-10-11
Onset:2006-10-18
Submitted:2006-10-20
Entered:2006-10-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / NOVARTIS VACCINES AND DIAGNOSTICS 70089 / 1 RA / IM
VARZOS: ZOSTER (ZOSTAVAX) / MERCK & CO. INC. 0981F / 1 LA / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Anaemia, Dehydration, Hydronephrosis, Prostatic disorder, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Meds: metamucil, Ergocalciferol, Flomax, Lidocaine/Prilocaine topical, Hyoscyamine sulfate PRN, vitamins, Vitamin D, and sulfamethoxazole-trimethoprim.
Current Illness: superficial wound infection with B. fragilis.
Preexisting Conditions: allergy-phenergan history of colectomy for ulcerative colitis, osteoporosis, vitamin D deficiency PMH: COPD, Hypertension, Hemorrhoids, Joint pain, Sleep Apnea, cataracts, osteoporosis, diverticuli, low back pain, anemia, sinusitis, allergic rhinitis and testosterone deficiency. Recent surgery for bowel obstruction with wound dehiscence.
Allergies:
Diagnostic Lab Data: CBC no shift, CXR, Urine culture, blood cultures negative. LABS and DIAGNOSTICS: Renal US shows mild left hydronephrosis and moderate postvoid residual.
CDC 'Split Type':

Write-up: Received Zostavax and flu vaccine on 10/11. Developed fever 102.4 documented on 10/18. Was admitted for IV fluids. No other obvious source found. Had recently been hospitalized and operated for small obstruction which made him susceptible to the dehydration factor. No infectious etiology found related to fever. Hospital and PCP MRs received documenting 73 yr old who presents 1 week s/p Flu and Zostavx immunizations with fever, dysuria, and not feeling well. Patient reports need to push on bladder to empty. Admitted to hospital for hydration and IV antibiotics. Impression: "Suspect UTI from inability to empty bladder well. Doubt reaction to Zostavax" Discharge DX: Fever, Dehydration, Hydronephrosis, BPH with outlet obstruction, concha bullosa, anemia, and past hx. of abd. incision dehiscence.


Changed on 10/14/2018

VAERS ID: 265040 Before After
VAERS Form:1
Age:74.0
Sex:Male
Location:Missouri
Vaccinated:2006-10-11
Onset:2006-10-18
Submitted:2006-10-20
Entered:2006-10-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / NOVARTIS VACCINES AND DIAGNOSTICS 70089 / 1 RA / IM
VARZOS: ZOSTER (ZOSTAVAX) / MERCK & CO. INC. 0981F / 1 LA / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Anaemia, Dehydration, Hydronephrosis, Prostatic disorder, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Meds: metamucil, Ergocalciferol, Flomax, Lidocaine/Prilocaine topical, Hyoscyamine sulfate PRN, vitamins, Vitamin D, and sulfamethoxazole-trimethoprim.
Current Illness: superficial wound infection with B. fragilis.
Preexisting Conditions: allergy-phenergan history of colectomy for ulcerative colitis, osteoporosis, vitamin D deficiency PMH: COPD, Hypertension, Hemorrhoids, Joint pain, Sleep Apnea, cataracts, osteoporosis, diverticuli, low back pain, anemia, sinusitis, allergic rhinitis and testosterone deficiency. Recent surgery for bowel obstruction with wound dehiscence.
Allergies:
Diagnostic Lab Data: CBC no shift, CXR, Urine culture, blood cultures negative. LABS and DIAGNOSTICS: Renal US shows mild left hydronephrosis and moderate postvoid residual.
CDC 'Split Type':

Write-up: Received Zostavax and flu vaccine on 10/11. Developed fever 102.4 documented on 10/18. Was admitted for IV fluids. No other obvious source found. Had recently been hospitalized and operated for small obstruction which made him susceptible to the dehydration factor. No infectious etiology found related to fever. Hospital and PCP MRs received documenting 73 yr old who presents 1 week s/p Flu and Zostavx immunizations with fever, dysuria, and not feeling well. Patient reports need to push on bladder to empty. Admitted to hospital for hydration and IV antibiotics. Impression: "Suspect UTI from inability to empty bladder well. Doubt reaction to Zostavax" Discharge DX: Fever, Dehydration, Hydronephrosis, BPH with outlet obstruction, concha bullosa, anemia, and past hx. of abd. incision dehiscence.


Changed on 8/14/2019

VAERS ID: 265040 Before After
VAERS Form:1
Age:74.0
Sex:Male
Location:Missouri
Vaccinated:2006-10-11
Onset:2006-10-18
Submitted:2006-10-20
Entered:2006-10-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / NOVARTIS VACCINES AND DIAGNOSTICS 70089 / 1 RA / IM
VARZOS: ZOSTER (ZOSTAVAX) ZOSTER LIVE (ZOSTAVAX) / MERCK & CO. INC. 0981F / 1 LA / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Anaemia, Dehydration, Hydronephrosis, Prostatic disorder, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Meds: metamucil, Ergocalciferol, Flomax, Lidocaine/Prilocaine topical, Hyoscyamine sulfate PRN, vitamins, Vitamin D, and sulfamethoxazole-trimethoprim.
Current Illness: superficial wound infection with B. fragilis.
Preexisting Conditions: allergy-phenergan history of colectomy for ulcerative colitis, osteoporosis, vitamin D deficiency PMH: COPD, Hypertension, Hemorrhoids, Joint pain, Sleep Apnea, cataracts, osteoporosis, diverticuli, low back pain, anemia, sinusitis, allergic rhinitis and testosterone deficiency. Recent surgery for bowel obstruction with wound dehiscence.
Allergies:
Diagnostic Lab Data: CBC no shift, CXR, Urine culture, blood cultures negative. LABS and DIAGNOSTICS: Renal US shows mild left hydronephrosis and moderate postvoid residual.
CDC 'Split Type':

Write-up: Received Zostavax and flu vaccine on 10/11. Developed fever 102.4 documented on 10/18. Was admitted for IV fluids. No other obvious source found. Had recently been hospitalized and operated for small obstruction which made him susceptible to the dehydration factor. No infectious etiology found related to fever. Hospital and PCP MRs received documenting 73 yr old who presents 1 week s/p Flu and Zostavx immunizations with fever, dysuria, and not feeling well. Patient reports need to push on bladder to empty. Admitted to hospital for hydration and IV antibiotics. Impression: "Suspect UTI from inability to empty bladder well. Doubt reaction to Zostavax" Discharge DX: Fever, Dehydration, Hydronephrosis, BPH with outlet obstruction, concha bullosa, anemia, and past hx. of abd. incision dehiscence.


Changed on 12/24/2020

VAERS ID: 265040 Before After
VAERS Form:1
Age:74.0
Sex:Male
Location:Missouri
Vaccinated:2006-10-11
Onset:2006-10-18
Submitted:2006-10-20
Entered:2006-10-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / NOVARTIS VACCINES AND DIAGNOSTICS 70089 / 1 RA / IM
VARZOS: ZOSTER LIVE (ZOSTAVAX) / MERCK & CO. INC. 0981F / 1 LA / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Anaemia, Dehydration, Hydronephrosis, Prostatic disorder, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Meds: metamucil, Ergocalciferol, Flomax, Lidocaine/Prilocaine topical, Hyoscyamine sulfate PRN, vitamins, Vitamin D, and sulfamethoxazole-trimethoprim.
Current Illness: superficial wound infection with B. fragilis.
Preexisting Conditions: allergy-phenergan history of colectomy for ulcerative colitis, osteoporosis, vitamin D deficiency PMH: COPD, Hypertension, Hemorrhoids, Joint pain, Sleep Apnea, cataracts, osteoporosis, diverticuli, low back pain, anemia, sinusitis, allergic rhinitis and testosterone deficiency. Recent surgery for bowel obstruction with wound dehiscence.
Allergies:
Diagnostic Lab Data: CBC no shift, CXR, Urine culture, blood cultures negative. LABS and DIAGNOSTICS: Renal US shows mild left hydronephrosis and moderate postvoid residual.
CDC 'Split Type':

Write-up: Received Zostavax and flu vaccine on 10/11. Developed fever 102.4 documented on 10/18. Was admitted for IV fluids. No other obvious source found. Had recently been hospitalized and operated for small obstruction which made him susceptible to the dehydration factor. No infectious etiology found related to fever. Hospital and PCP MRs received documenting 73 yr old who presents 1 week s/p Flu and Zostavx immunizations with fever, dysuria, and not feeling well. Patient reports need to push on bladder to empty. Admitted to hospital for hydration and IV antibiotics. Impression: "Suspect UTI from inability to empty bladder well. Doubt reaction to Zostavax" Discharge DX: Fever, Dehydration, Hydronephrosis, BPH with outlet obstruction, concha bullosa, anemia, and past hx. of abd. incision dehiscence.


Changed on 12/30/2020

VAERS ID: 265040 Before After
VAERS Form:1
Age:74.0
Sex:Male
Location:Missouri
Vaccinated:2006-10-11
Onset:2006-10-18
Submitted:2006-10-20
Entered:2006-10-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / NOVARTIS VACCINES AND DIAGNOSTICS 70089 / 1 RA / IM
VARZOS: ZOSTER LIVE (ZOSTAVAX) / MERCK & CO. INC. 0981F / 1 LA / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Anaemia, Dehydration, Hydronephrosis, Prostatic disorder, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Meds: metamucil, Ergocalciferol, Flomax, Lidocaine/Prilocaine topical, Hyoscyamine sulfate PRN, vitamins, Vitamin D, and sulfamethoxazole-trimethoprim.
Current Illness: superficial wound infection with B. fragilis.
Preexisting Conditions: allergy-phenergan history of colectomy for ulcerative colitis, osteoporosis, vitamin D deficiency PMH: COPD, Hypertension, Hemorrhoids, Joint pain, Sleep Apnea, cataracts, osteoporosis, diverticuli, low back pain, anemia, sinusitis, allergic rhinitis and testosterone deficiency. Recent surgery for bowel obstruction with wound dehiscence.
Allergies:
Diagnostic Lab Data: CBC no shift, CXR, Urine culture, blood cultures negative. LABS and DIAGNOSTICS: Renal US shows mild left hydronephrosis and moderate postvoid residual.
CDC 'Split Type':

Write-up: Received Zostavax and flu vaccine on 10/11. Developed fever 102.4 documented on 10/18. Was admitted for IV fluids. No other obvious source found. Had recently been hospitalized and operated for small obstruction which made him susceptible to the dehydration factor. No infectious etiology found related to fever. Hospital and PCP MRs received documenting 73 yr old who presents 1 week s/p Flu and Zostavx immunizations with fever, dysuria, and not feeling well. Patient reports need to push on bladder to empty. Admitted to hospital for hydration and IV antibiotics. Impression: "Suspect UTI from inability to empty bladder well. Doubt reaction to Zostavax" Discharge DX: Fever, Dehydration, Hydronephrosis, BPH with outlet obstruction, concha bullosa, anemia, and past hx. of abd. incision dehiscence.


Changed on 5/7/2021

VAERS ID: 265040 Before After
VAERS Form:1
Age:74.0
Sex:Male
Location:Missouri
Vaccinated:2006-10-11
Onset:2006-10-18
Submitted:2006-10-20
Entered:2006-10-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / NOVARTIS VACCINES AND DIAGNOSTICS 70089 / 1 RA / IM
VARZOS: ZOSTER LIVE (ZOSTAVAX) / MERCK & CO. INC. 0981F / 1 LA / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Anaemia, Dehydration, Hydronephrosis, Prostatic disorder, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Meds: metamucil, Ergocalciferol, Flomax, Lidocaine/Prilocaine topical, Hyoscyamine sulfate PRN, vitamins, Vitamin D, and sulfamethoxazole-trimethoprim.
Current Illness: superficial wound infection with B. fragilis.
Preexisting Conditions: allergy-phenergan history of colectomy for ulcerative colitis, osteoporosis, vitamin D deficiency PMH: COPD, Hypertension, Hemorrhoids, Joint pain, Sleep Apnea, cataracts, osteoporosis, diverticuli, low back pain, anemia, sinusitis, allergic rhinitis and testosterone deficiency. Recent surgery for bowel obstruction with wound dehiscence.
Allergies:
Diagnostic Lab Data: CBC no shift, CXR, Urine culture, blood cultures negative. LABS and DIAGNOSTICS: Renal US shows mild left hydronephrosis and moderate postvoid residual.
CDC 'Split Type':

Write-up: Received Zostavax and flu vaccine on 10/11. Developed fever 102.4 documented on 10/18. Was admitted for IV fluids. No other obvious source found. Had recently been hospitalized and operated for small obstruction which made him susceptible to the dehydration factor. No infectious etiology found related to fever. Hospital and PCP MRs received documenting 73 yr old who presents 1 week s/p Flu and Zostavx immunizations with fever, dysuria, and not feeling well. Patient reports need to push on bladder to empty. Admitted to hospital for hydration and IV antibiotics. Impression: "Suspect UTI from inability to empty bladder well. Doubt reaction to Zostavax" Discharge DX: Fever, Dehydration, Hydronephrosis, BPH with outlet obstruction, concha bullosa, anemia, and past hx. of abd. incision dehiscence.


Changed on 5/21/2021

VAERS ID: 265040 Before After
VAERS Form:1
Age:74.0
Sex:Male
Location:Missouri
Vaccinated:2006-10-11
Onset:2006-10-18
Submitted:2006-10-20
Entered:2006-10-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / NOVARTIS VACCINES AND DIAGNOSTICS 70089 / 1 RA / IM
VARZOS: ZOSTER LIVE (ZOSTAVAX) / MERCK & CO. INC. 0981F / 1 LA / SC

Administered by: Unknown      Purchased by: Unknown
Symptoms: Anaemia, Dehydration, Hydronephrosis, Prostatic disorder, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Meds: metamucil, Ergocalciferol, Flomax, Lidocaine/Prilocaine topical, Hyoscyamine sulfate PRN, vitamins, Vitamin D, and sulfamethoxazole-trimethoprim.
Current Illness: superficial wound infection with B. fragilis.
Preexisting Conditions: allergy-phenergan history of colectomy for ulcerative colitis, osteoporosis, vitamin D deficiency PMH: COPD, Hypertension, Hemorrhoids, Joint pain, Sleep Apnea, cataracts, osteoporosis, diverticuli, low back pain, anemia, sinusitis, allergic rhinitis and testosterone deficiency. Recent surgery for bowel obstruction with wound dehiscence.
Allergies:
Diagnostic Lab Data: CBC no shift, CXR, Urine culture, blood cultures negative. LABS and DIAGNOSTICS: Renal US shows mild left hydronephrosis and moderate postvoid residual.
CDC 'Split Type':

Write-up: Received Zostavax and flu vaccine on 10/11. Developed fever 102.4 documented on 10/18. Was admitted for IV fluids. No other obvious source found. Had recently been hospitalized and operated for small obstruction which made him susceptible to the dehydration factor. No infectious etiology found related to fever. Hospital and PCP MRs received documenting 73 yr old who presents 1 week s/p Flu and Zostavx immunizations with fever, dysuria, and not feeling well. Patient reports need to push on bladder to empty. Admitted to hospital for hydration and IV antibiotics. Impression: "Suspect UTI from inability to empty bladder well. Doubt reaction to Zostavax" Discharge DX: Fever, Dehydration, Hydronephrosis, BPH with outlet obstruction, concha bullosa, anemia, and past hx. of abd. incision dehiscence.

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