This is VAERS ID 266811
First Appeared on 12/30/2006 |
| VAERS ID: |
266811
|
Vaccinated: |
2006-09-06 |
| Age: |
89.0 |
Onset: |
2006-10-16 |
| Gender: |
Female |
Submitted: |
2006-11-10 |
| Location: |
Illinois |
Entered: |
2006-11-15 |
|
| Life Threatening? No |
| Died? No |
| Permanent Disability? Yes |
| Recovered? No |
| ER or Doctor Visit? Yes |
| Hospitalized? No |
| Previous Vaccinations: |
| Other Medications: Tylenol, Allopurinol, aspirin, Carbatrol, Furosemide, Synthroid, Zocor, Spironolactone. |
| Current Illness: |
| Preexisting Conditions: Upper extremity mass, mass excision, gout, skin cancer, cellulitis, heart attack, cholelithiasis, Arthritis, coronary artery disease, shingles, cholesterol levels raised. |
| Diagnostic Lab Data: |
| CDC 'Split Type': |
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| Vaccination |
Manufacturer |
Lot |
Dose |
Route |
Site |
| VARZOS: ZOSTER VACCINE LIVE (OKA/MERCK) (ZOSTAVAX) |
MERCK & CO. INC. |
|
|
SC |
UN |
|
| Administered by: Other
Purchased by: Unknown |
| Symptoms: Back pain, Condition aggravated, Pain, Sleep disorder |
| Write-up: Information has been received from a medical assistant and an 89 year old female consumer with arthritis, increased cholesterol levels, coronary artery disease and shingles. since 9/28/1992 and a history of a mass in the right hand with surgery, gout, ski"n cancer on her face in 1984, cellulitis, cholelithiasis in 1978 and a heart attack in 1988 and 1989, she had angiogram in 1990 and a 30% double vessel occlusion. On 9/6/06 was vaccinated SC in the right arm with a dose of Varicella zoster virus vaccine l |
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|
Changed on 12/8/2009 |
| VAERS ID: |
266811 Before
After
|
Vaccinated: |
2006-09-06 |
| Age: |
89.0/88.0 |
Onset: |
2006-10-16 |
| Gender: |
Female |
Submitted: |
2006-11-10 |
| Location: |
Illinois |
Entered: |
2006-11-15 |
|
| Life Threatening? No |
| Died? No |
| Permanent Disability? Yes |
| Recovered? No |
| ER or Doctor Visit? Yes |
| Hospitalized? No |
| Previous Vaccinations: |
| Other Medications: Tylenol, Allopurinol, aspirin, Carbatrol, Furosemide, Synthroid, Zocor, Spironolactone. |
| Current Illness: |
| Preexisting Conditions: Upper extremity mass, mass excision, gout, skin cancer, cellulitis, heart attack, cholelithiasis, Arthritis, coronary artery disease, shingles, cholesterol levels raised. |
| Diagnostic Lab Data: |
CDC 'Split Type':
(blank)
WAES0611USA00187 |
|
| Vaccination |
Manufacturer |
Lot |
Dose |
Route |
Site |
| VARZOS: ZOSTER VACCINE LIVE (OKA/MERCK) (ZOSTAVAX)/ZOSTER (ZOSTAVAX) |
MERCK & CO. INC. |
|
|
SC |
UN/RA |
|
| Administered by: Other
Purchased by: Unknown/Other |
| Symptoms: Back pain, Condition aggravated, Pain, Sleep disorder |
Write-up:
Information has been received from a medical assistant and an 89 year old female consumer with arthritis, increased cholesterol levels, coronary artery disease and shingles. since 9/28/1992 and a history of a mass in the right hand with surgery, gout, ski"n skin cancer on her face in 1984, cellulitis, cholelithiasis in 1978 and a heart attack in 1988 and 1989, she had angiogram in 1990 and a 30% double vessel occlusion. On 9/6/06 was vaccinated SC in the right arm with a dose of Varicella zoster virus vaccine l live. There was no concomitant vaccinations. Concomitant therapy included Carbatrol, Allopurinol, Synthroid, Simvastatin, Spironolactone, aspirin and Tylenol. The pt thought that one shot of the vaccine would cure her shingles. It was noted that the pt was not experiencing pain from the injection site. the medical assistant also stated that the pt had pain from a previous shingles experience, however, the pain is reportedly worse since receiving the vaccine. The pt was worse later in the day and has interrupted the pts ability to sleep at night. It was reported that the pt did not experienced a rash. The pt had reported that she was previously seen by a neurologist, had acupuncture but nothing works for her shingles. About 3 weeks ago, on approx 10/16/06, the pt was experiencing severe pain in her back area after receiving varicella zoster virus vaccine live. At the time of this report, the pt had not recovered. It was reported that the pts experienced were disabling. Additional information has been requested.
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New Search
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Link To This Search Result:
http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=266811&WAYBACKHISTORY=ON
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