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From the 1/14/2022 release of VAERS data:

This is VAERS ID 270421

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Case Details

VAERS ID: 270421 (history)  
Form: Version 1.0  
Age: 62.0  
Sex: Female  
Location: California  
   Days after vaccination:35
Submitted: 2007-01-11
   Days after onset:6
Entered: 2007-01-12
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Herpes zoster, Infection, Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: (therapy unspecified) (therapy unspecified) (therapy unspecified)
Current Illness:
Preexisting Conditions: MEDICAL HISTORY: Hysterectomy CONCURRENT CONDITIONS: Shingles, Cholesterol, Penicillin allergy, Type II diabetes mellitus, Hypertension
Diagnostic Lab Data:
CDC Split Type: WAES0701USA00874

Write-up: Information had been received from a consumer concerning his 62 year old wife with shingles around one of her ears, a penicillin allergy and a history of hysterectomy who was vaccinated in December 2006 with a dose of varicella zoster virus vaccine live. Concomitant therapy included medicine for diabetes, high blood pressure and cholesterol. Approximately twelve days after vaccination, she broke out with rashes and hives all over her body. She was hospitalized on 05 Jan 2007. She was currently still hospitalized. Unspecified laboratory test were performed, the results were not reported. The husband mentioned that approximately one month before his wife was vaccinated she had her first outbreak of shingles in the are around one of her ears. She had almost fully recovered from the shingles at the time she was vaccinated. At the time of the report the patient was not recovered. There was no product quality complaint involved. Additional information has been requested.

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