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This is VAERS ID 269643

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History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 269643
VAERS Form:
Age:60.0
Sex:Female
Location:New Jersey
Vaccinated:2006-12-01
Onset:2006-12-04
Submitted:2006-12-20
Entered:2006-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER VACCINE LIVE (OKA/MERCK) (ZOSTAVAX) / MERCK & CO. INC. - / - UN / -

Administered by: Other      Purchased by: Unknown
Symptoms: Hypoaesthesia, Pyrexia, Abasia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 11     Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: diagnostic laboratory, 12?/??/2006, /"blood work,/" results not reported; body temp, 12?/??/2006, 100 degrees.
CDC 'Split Type':

Write-up: Information has been received from a physician concerning an /"over 60/" year old female who in approximately December 2006 was vaccinated with a dose of ZOSTAVAX. Subsequently, 3-4 days after receiving ZOSTAVAX, the patient developed numbness in her legs", lips and around her mouth, and a fever. The patient /"could not walk/" due to this event. The patient was referred to a neurologist to rule out Guillain Barre Syndrome. The patient was also referred to an infectious disease specialist to determine if th


Changed on 12/8/2009

VAERS ID: 269643 Before After
VAERS Form:
Age:60.0
Sex:Female
Location:New Jersey
Vaccinated:2006-12-01
Onset:2006-12-04
Submitted:2006-12-20
Entered:2006-12-27
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: Hypoaesthesia, Pyrexia, Abasia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 11     Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: diagnostic laboratory, 12?/??/2006, /"blood work,/" "blood work," results not reported; body temp, 12?/??/2006, 100 degrees.
CDC 'Split Type': (blank) WAES0612USA02676

Write-up: Information has been received from a physician concerning an /"over 60/" "over 60" year old female who in approximately December 2006 was vaccinated with a dose of ZOSTAVAX. Subsequently, 3-4 days after receiving ZOSTAVAX, the patient developed numbness in her legs", legs, lips and around her mouth, and a fever. The patient /"could "could not walk/" walk" due to this event. The patient was referred to a neurologist to rule out Guillain Barre Syndrome. The patient was also referred to an infectious disease specialist to determine if th the event was vaccine related. At the time of the report the patient''s numbness had improved but she was still spiking a temperature of 100-101 degrees. Unspecified "blood work" was performed. The patient was discharged from the hospital after 11 days as an inpatient. There was no product quality complaint involved. No additional information was available. The reporter considered the patient''s events to be disabling and serious for hospitalization. Additional information has been requested.


Changed on 2/5/2010

VAERS ID: 269643 Before After
VAERS Form:
Age:60.0
Sex:Female
Location:New Jersey
Vaccinated:2006-12-01
Onset:2006-12-04
Submitted:2006-12-20
Entered:2006-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER (ZOSTAVAX) / MERCK & CO. INC. - / - UN / - UN

Administered by: Other      Purchased by: Other
Symptoms: Hypoaesthesia, Pyrexia, Abasia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 11     Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: diagnostic laboratory, 12?/??/2006, "blood work," results not reported; body temp, 12?/??/2006, 100 degrees.
CDC 'Split Type': WAES0612USA02676

Write-up: Information has been received from a physician concerning an "over 60" year old female who in approximately December 2006 2006, was vaccinated with a dose of ZOSTAVAX. Subsequently, 3-4 days after receiving ZOSTAVAX, ZOSTAVAX the patient developed numbness in her legs, lips and around her mouth, and a fever. The patient "could not walk" due to this event. The patient was referred to a neurologist to rule out Guillain Barre Guillain-Barre Syndrome. The patient was also referred to an infectious disease specialist to determine if the event was vaccine related. At the time of the report the patient''s numbness had improved but she was still spiking a temperature of 100-101 degrees. Unspecified "blood work" was performed. The patient was discharged from the hospital after 11 days as an inpatient. There was no product quality complaint involved. No additional information was available. The reporter considered the patient''s events to be disabling and serious for hospitalization. Additional information has been requested.


Changed on 6/14/2014

VAERS ID: 269643 Before After
VAERS Form:
Age:60.0
Sex:Female
Location:New Jersey
Vaccinated:2006-12-01
Onset:2006-12-04
Submitted:2006-12-20
Entered:2006-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER (ZOSTAVAX) / MERCK & CO. INC. - / - UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Hypoaesthesia, Pyrexia, Abasia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 11     Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: diagnostic laboratory, 12?/??/2006, "blood work," results not reported; body temp, 12?/??/2006, 100 degrees.
CDC 'Split Type': WAES0612USA02676

Write-up: Information has been received from a physician concerning an "over 60" year old female who in approximately December 2006, was vaccinated with a dose of ZOSTAVAX. Subsequently, 3-4 days after receiving ZOSTAVAX the patient developed numbness in her legs, lips and around her mouth, and a fever. The patient "could not walk" due to this event. The patient was referred to a neurologist to rule out Guillain-Barre Syndrome. The patient was also referred to an infectious disease specialist to determine if the event was vaccine related. At the time of the report the patient''s numbness had improved but she was still spiking a temperature of 100-101 degrees. Unspecified "blood work" was performed. The patient was discharged from the hospital after 11 days as an inpatient. There was no product quality complaint involved. No additional information was available. The reporter considered the patient''s events to be disabling and serious for hospitalization. Additional information has been requested.


Changed on 2/14/2017

VAERS ID: 269643 Before After
VAERS Form:
Age:60.0
Sex:Female
Location:New Jersey
Vaccinated:2006-12-01
Onset:2006-12-04
Submitted:2006-12-20
Entered:2006-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER (ZOSTAVAX) / MERCK & CO. INC. - / - UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Hypoaesthesia, Pyrexia, Abasia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 11     Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: diagnostic laboratory, 12?/??/2006, "blood work," results not reported; body temp, 12?/??/2006, 100 degrees.
CDC 'Split Type': WAES0612USA02676

Write-up: Information has been received from a physician concerning an "over 60" year old female who in approximately December 2006, was vaccinated with a dose of ZOSTAVAX. Subsequently, 3-4 days after receiving ZOSTAVAX the patient developed numbness in her legs, lips and around her mouth, and a fever. The patient "could not walk" due to this event. The patient was referred to a neurologist to rule out Guillain-Barre Syndrome. The patient was also referred to an infectious disease specialist to determine if the event was vaccine related. At the time of the report the patient''s numbness had improved but she was still spiking a temperature of 100-101 degrees. Unspecified "blood work" was performed. The patient was discharged from the hospital after 11 days as an inpatient. There was no product quality complaint involved. No additional information was available. The reporter considered the patient''s events to be disabling and serious for hospitalization. Additional information has been requested.


Changed on 9/14/2017

VAERS ID: 269643 Before After
VAERS Form:(blank) 1
Age:60.0
Sex:Female
Location:New Jersey
Vaccinated:2006-12-01
Onset:2006-12-04
Submitted:2006-12-20
Entered:2006-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER (ZOSTAVAX) / MERCK & CO. INC. - / - UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Hypoaesthesia, Pyrexia, Abasia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 11     Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: diagnostic laboratory, 12?/??/2006, "blood work," results not reported; body temp, 12?/??/2006, 100 degrees.
CDC 'Split Type': WAES0612USA02676

Write-up: Information has been received from a physician concerning an "over 60" year old female who in approximately December 2006, was vaccinated with a dose of ZOSTAVAX. Subsequently, 3-4 days after receiving ZOSTAVAX the patient developed numbness in her legs, lips and around her mouth, and a fever. The patient "could not walk" due to this event. The patient was referred to a neurologist to rule out Guillain-Barre Syndrome. The patient was also referred to an infectious disease specialist to determine if the event was vaccine related. At the time of the report the patient''s numbness had improved but she was still spiking a temperature of 100-101 degrees. Unspecified "blood work" was performed. The patient was discharged from the hospital after 11 days as an inpatient. There was no product quality complaint involved. No additional information was available. The reporter considered the patient''s events to be disabling and serious for hospitalization. Additional information has been requested.


Changed on 2/14/2018

VAERS ID: 269643 Before After
VAERS Form:1
Age:60.0
Sex:Female
Location:New Jersey
Vaccinated:2006-12-01
Onset:2006-12-04
Submitted:2006-12-20
Entered:2006-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER (ZOSTAVAX) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Hypoaesthesia, Pyrexia, Abasia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 11     Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: diagnostic laboratory, 12?/??/2006, "blood work," results not reported; body temp, 12?/??/2006, 100 degrees.
CDC 'Split Type': WAES0612USA02676

Write-up: Information has been received from a physician concerning an "over 60" year old female who in approximately December 2006, was vaccinated with a dose of ZOSTAVAX. Subsequently, 3-4 days after receiving ZOSTAVAX the patient developed numbness in her legs, lips and around her mouth, and a fever. The patient "could not walk" due to this event. The patient was referred to a neurologist to rule out Guillain-Barre Syndrome. The patient was also referred to an infectious disease specialist to determine if the event was vaccine related. At the time of the report the patient''s numbness had improved but she was still spiking a temperature of 100-101 degrees. Unspecified "blood work" was performed. The patient was discharged from the hospital after 11 days as an inpatient. There was no product quality complaint involved. No additional information was available. The reporter considered the patient''s events to be disabling and serious for hospitalization. Additional information has been requested.


Changed on 6/14/2018

VAERS ID: 269643 Before After
VAERS Form:1
Age:60.0
Sex:Female
Location:New Jersey
Vaccinated:2006-12-01
Onset:2006-12-04
Submitted:2006-12-20
Entered:2006-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER (ZOSTAVAX) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Hypoaesthesia, Pyrexia, Abasia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 11     Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: diagnostic laboratory, 12?/??/2006, "blood work," results not reported; body temp, 12?/??/2006, 100 degrees.
CDC 'Split Type': WAES0612USA02676

Write-up: Information has been received from a physician concerning an "over 60" year old female who in approximately December 2006, was vaccinated with a dose of ZOSTAVAX. Subsequently, 3-4 days after receiving ZOSTAVAX the patient developed numbness in her legs, lips and around her mouth, and a fever. The patient "could not walk" due to this event. The patient was referred to a neurologist to rule out Guillain-Barre Syndrome. The patient was also referred to an infectious disease specialist to determine if the event was vaccine related. At the time of the report the patient''s numbness had improved but she was still spiking a temperature of 100-101 degrees. Unspecified "blood work" was performed. The patient was discharged from the hospital after 11 days as an inpatient. There was no product quality complaint involved. No additional information was available. The reporter considered the patient''s events to be disabling and serious for hospitalization. Additional information has been requested.


Changed on 8/14/2018

VAERS ID: 269643 Before After
VAERS Form:1
Age:60.0
Sex:Female
Location:New Jersey
Vaccinated:2006-12-01
Onset:2006-12-04
Submitted:2006-12-20
Entered:2006-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER (ZOSTAVAX) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Hypoaesthesia, Pyrexia, Abasia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 11     Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: diagnostic laboratory, 12?/??/2006, "blood work," results not reported; body temp, 12?/??/2006, 100 degrees.
CDC 'Split Type': WAES0612USA02676

Write-up: Information has been received from a physician concerning an "over 60" year old female who in approximately December 2006, was vaccinated with a dose of ZOSTAVAX. Subsequently, 3-4 days after receiving ZOSTAVAX the patient developed numbness in her legs, lips and around her mouth, and a fever. The patient "could not walk" due to this event. The patient was referred to a neurologist to rule out Guillain-Barre Syndrome. The patient was also referred to an infectious disease specialist to determine if the event was vaccine related. At the time of the report the patient''s numbness had improved but she was still spiking a temperature of 100-101 degrees. Unspecified "blood work" was performed. The patient was discharged from the hospital after 11 days as an inpatient. There was no product quality complaint involved. No additional information was available. The reporter considered the patient''s events to be disabling and serious for hospitalization. Additional information has been requested.


Changed on 9/14/2018

VAERS ID: 269643 Before After
VAERS Form:1
Age:60.0
Sex:Female
Location:New Jersey
Vaccinated:2006-12-01
Onset:2006-12-04
Submitted:2006-12-20
Entered:2006-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER (ZOSTAVAX) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Hypoaesthesia, Pyrexia, Abasia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 11     Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: diagnostic laboratory, 12?/??/2006, "blood work," results not reported; body temp, 12?/??/2006, 100 degrees.
CDC 'Split Type': WAES0612USA02676

Write-up: Information has been received from a physician concerning an "over 60" year old female who in approximately December 2006, was vaccinated with a dose of ZOSTAVAX. Subsequently, 3-4 days after receiving ZOSTAVAX the patient developed numbness in her legs, lips and around her mouth, and a fever. The patient "could not walk" due to this event. The patient was referred to a neurologist to rule out Guillain-Barre Syndrome. The patient was also referred to an infectious disease specialist to determine if the event was vaccine related. At the time of the report the patient''s numbness had improved but she was still spiking a temperature of 100-101 degrees. Unspecified "blood work" was performed. The patient was discharged from the hospital after 11 days as an inpatient. There was no product quality complaint involved. No additional information was available. The reporter considered the patient''s events to be disabling and serious for hospitalization. Additional information has been requested.


Changed on 10/14/2018

VAERS ID: 269643 Before After
VAERS Form:1
Age:60.0
Sex:Female
Location:New Jersey
Vaccinated:2006-12-01
Onset:2006-12-04
Submitted:2006-12-20
Entered:2006-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER (ZOSTAVAX) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Hypoaesthesia, Pyrexia, Abasia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 11     Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: diagnostic laboratory, 12?/??/2006, "blood work," results not reported; body temp, 12?/??/2006, 100 degrees.
CDC 'Split Type': WAES0612USA02676

Write-up: Information has been received from a physician concerning an "over 60" year old female who in approximately December 2006, was vaccinated with a dose of ZOSTAVAX. Subsequently, 3-4 days after receiving ZOSTAVAX the patient developed numbness in her legs, lips and around her mouth, and a fever. The patient "could not walk" due to this event. The patient was referred to a neurologist to rule out Guillain-Barre Syndrome. The patient was also referred to an infectious disease specialist to determine if the event was vaccine related. At the time of the report the patient''s numbness had improved but she was still spiking a temperature of 100-101 degrees. Unspecified "blood work" was performed. The patient was discharged from the hospital after 11 days as an inpatient. There was no product quality complaint involved. No additional information was available. The reporter considered the patient''s events to be disabling and serious for hospitalization. Additional information has been requested.


Changed on 8/14/2019

VAERS ID: 269643 Before After
VAERS Form:1
Age:60.0
Sex:Female
Location:New Jersey
Vaccinated:2006-12-01
Onset:2006-12-04
Submitted:2006-12-20
Entered:2006-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER (ZOSTAVAX) ZOSTER LIVE (ZOSTAVAX) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Hypoaesthesia, Pyrexia, Abasia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 11     Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: diagnostic laboratory, 12?/??/2006, "blood work," results not reported; body temp, 12?/??/2006, 100 degrees.
CDC 'Split Type': WAES0612USA02676

Write-up: Information has been received from a physician concerning an "over 60" year old female who in approximately December 2006, was vaccinated with a dose of ZOSTAVAX. Subsequently, 3-4 days after receiving ZOSTAVAX the patient developed numbness in her legs, lips and around her mouth, and a fever. The patient "could not walk" due to this event. The patient was referred to a neurologist to rule out Guillain-Barre Syndrome. The patient was also referred to an infectious disease specialist to determine if the event was vaccine related. At the time of the report the patient''s numbness had improved but she was still spiking a temperature of 100-101 degrees. Unspecified "blood work" was performed. The patient was discharged from the hospital after 11 days as an inpatient. There was no product quality complaint involved. No additional information was available. The reporter considered the patient''s events to be disabling and serious for hospitalization. Additional information has been requested.


Changed on 12/24/2020

VAERS ID: 269643 Before After
VAERS Form:1
Age:60.0
Sex:Female
Location:New Jersey
Vaccinated:2006-12-01
Onset:2006-12-04
Submitted:2006-12-20
Entered:2006-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER LIVE (ZOSTAVAX) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Hypoaesthesia, Pyrexia, Abasia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 11     Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: diagnostic laboratory, 12?/??/2006, "blood work," results not reported; body temp, 12?/??/2006, 100 degrees.
CDC 'Split Type': WAES0612USA02676

Write-up: Information has been received from a physician concerning an "over 60" year old female who in approximately December 2006, was vaccinated with a dose of ZOSTAVAX. Subsequently, 3-4 days after receiving ZOSTAVAX the patient developed numbness in her legs, lips and around her mouth, and a fever. The patient "could not walk" due to this event. The patient was referred to a neurologist to rule out Guillain-Barre Syndrome. The patient was also referred to an infectious disease specialist to determine if the event was vaccine related. At the time of the report the patient''s numbness had improved but she was still spiking a temperature of 100-101 degrees. Unspecified "blood work" was performed. The patient was discharged from the hospital after 11 days as an inpatient. There was no product quality complaint involved. No additional information was available. The reporter considered the patient''s events to be disabling and serious for hospitalization. Additional information has been requested.


Changed on 12/30/2020

VAERS ID: 269643 Before After
VAERS Form:1
Age:60.0
Sex:Female
Location:New Jersey
Vaccinated:2006-12-01
Onset:2006-12-04
Submitted:2006-12-20
Entered:2006-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER LIVE (ZOSTAVAX) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Hypoaesthesia, Pyrexia, Abasia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 11     Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: diagnostic laboratory, 12?/??/2006, "blood work," results not reported; body temp, 12?/??/2006, 100 degrees.
CDC 'Split Type': WAES0612USA02676

Write-up: Information has been received from a physician concerning an "over 60" year old female who in approximately December 2006, was vaccinated with a dose of ZOSTAVAX. Subsequently, 3-4 days after receiving ZOSTAVAX the patient developed numbness in her legs, lips and around her mouth, and a fever. The patient "could not walk" due to this event. The patient was referred to a neurologist to rule out Guillain-Barre Syndrome. The patient was also referred to an infectious disease specialist to determine if the event was vaccine related. At the time of the report the patient''s numbness had improved but she was still spiking a temperature of 100-101 degrees. Unspecified "blood work" was performed. The patient was discharged from the hospital after 11 days as an inpatient. There was no product quality complaint involved. No additional information was available. The reporter considered the patient''s events to be disabling and serious for hospitalization. Additional information has been requested.


Changed on 5/7/2021

VAERS ID: 269643 Before After
VAERS Form:1
Age:60.0
Sex:Female
Location:New Jersey
Vaccinated:2006-12-01
Onset:2006-12-04
Submitted:2006-12-20
Entered:2006-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER LIVE (ZOSTAVAX) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Hypoaesthesia, Pyrexia, Abasia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 11     Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: diagnostic laboratory, 12?/??/2006, "blood work," results not reported; body temp, 12?/??/2006, 100 degrees.
CDC 'Split Type': WAES0612USA02676

Write-up: Information has been received from a physician concerning an "over 60" year old female who in approximately December 2006, was vaccinated with a dose of ZOSTAVAX. Subsequently, 3-4 days after receiving ZOSTAVAX the patient developed numbness in her legs, lips and around her mouth, and a fever. The patient "could not walk" due to this event. The patient was referred to a neurologist to rule out Guillain-Barre Syndrome. The patient was also referred to an infectious disease specialist to determine if the event was vaccine related. At the time of the report the patient''s numbness had improved but she was still spiking a temperature of 100-101 degrees. Unspecified "blood work" was performed. The patient was discharged from the hospital after 11 days as an inpatient. There was no product quality complaint involved. No additional information was available. The reporter considered the patient''s events to be disabling and serious for hospitalization. Additional information has been requested.


Changed on 5/21/2021

VAERS ID: 269643 Before After
VAERS Form:1
Age:60.0
Sex:Female
Location:New Jersey
Vaccinated:2006-12-01
Onset:2006-12-04
Submitted:2006-12-20
Entered:2006-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER LIVE (ZOSTAVAX) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Hypoaesthesia, Pyrexia, Abasia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 11     Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: diagnostic laboratory, 12?/??/2006, "blood work," results not reported; body temp, 12?/??/2006, 100 degrees.
CDC 'Split Type': WAES0612USA02676

Write-up: Information has been received from a physician concerning an "over 60" year old female who in approximately December 2006, was vaccinated with a dose of ZOSTAVAX. Subsequently, 3-4 days after receiving ZOSTAVAX the patient developed numbness in her legs, lips and around her mouth, and a fever. The patient "could not walk" due to this event. The patient was referred to a neurologist to rule out Guillain-Barre Syndrome. The patient was also referred to an infectious disease specialist to determine if the event was vaccine related. At the time of the report the patient''s numbness had improved but she was still spiking a temperature of 100-101 degrees. Unspecified "blood work" was performed. The patient was discharged from the hospital after 11 days as an inpatient. There was no product quality complaint involved. No additional information was available. The reporter considered the patient''s events to be disabling and serious for hospitalization. Additional information has been requested.

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