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This is VAERS ID 270421

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History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 270421
VAERS Form:
Age:62.0
Sex:Female
Location:California
Vaccinated:2006-12-01
Onset:2007-01-05
Submitted:2007-01-11
Entered:2007-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER (ZOSTAVAX) / MERCK & CO. INC. - / - UN / -

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

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: 0     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
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

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 hospi


Changed on 12/8/2009

VAERS ID: 270421 Before After
VAERS Form:
Age:62.0
Sex:Female
Location:California
Vaccinated:2006-12-01
Onset:2007-01-05
Submitted:2007-01-11
Entered:2007-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER (ZOSTAVAX) / MERCK & CO. INC. - / - UN / - UN

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

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: 0 (blank)     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
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) 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 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 hospi 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.


Changed on 1/5/2010

VAERS ID: 270421 Before After
VAERS Form:
Age:62.0
Sex:Female
Location:California
Vaccinated:2006-12-01
Onset:2007-01-05
Submitted:2007-01-11
Entered:2007-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER (ZOSTAVAX) / MERCK & CO. INC. - 1411F / - UN / UN

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

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: (therapy unspecified) (therapy unspecified) (therapy unspecified)
Current Illness:
Preexisting Conditions: MEDICAL HISTORY: Hysterectomy CONCURRENT CONDITIONS: Shingles, Cholesterol, Penicillin allergy, Type II diabetes mellitus, Hypertension
Allergies:
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.


Changed on 6/14/2014

VAERS ID: 270421 Before After
VAERS Form:
Age:62.0
Sex:Female
Location:California
Vaccinated:2006-12-01
Onset:2007-01-05
Submitted:2007-01-11
Entered:2007-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER (ZOSTAVAX) / MERCK & CO. INC. 1411F / - UN / UN

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

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: (therapy unspecified) (therapy unspecified) (therapy unspecified)
Current Illness:
Preexisting Conditions: MEDICAL HISTORY: Hysterectomy CONCURRENT CONDITIONS: Shingles, Cholesterol, Penicillin allergy, Type II diabetes mellitus, Hypertension
Allergies:
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.


Changed on 5/14/2017

VAERS ID: 270421 Before After
VAERS Form:
Age:62.0
Sex:Female
Location:California
Vaccinated:2006-12-01
Onset:2007-01-05
Submitted:2007-01-11
Entered:2007-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER (ZOSTAVAX) / MERCK & CO. INC. 1411F / - UN / UN

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

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: (therapy unspecified) (therapy unspecified) (therapy unspecified)
Current Illness:
Preexisting Conditions: MEDICAL HISTORY: Hysterectomy CONCURRENT CONDITIONS: Shingles, Cholesterol, Penicillin allergy, Type II diabetes mellitus, Hypertension
Allergies:
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.


Changed on 9/14/2017

VAERS ID: 270421 Before After
VAERS Form:(blank) 1
Age:62.0
Sex:Female
Location:California
Vaccinated:2006-12-01
Onset:2007-01-05
Submitted:2007-01-11
Entered:2007-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER (ZOSTAVAX) / MERCK & CO. INC. 1411F / - UNK UN / UN

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

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: (therapy unspecified) (therapy unspecified) (therapy unspecified)
Current Illness:
Preexisting Conditions: MEDICAL HISTORY: Hysterectomy CONCURRENT CONDITIONS: Shingles, Cholesterol, Penicillin allergy, Type II diabetes mellitus, Hypertension
Allergies:
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.


Changed on 2/14/2018

VAERS ID: 270421 Before After
VAERS Form:1
Age:62.0
Sex:Female
Location:California
Vaccinated:2006-12-01
Onset:2007-01-05
Submitted:2007-01-11
Entered:2007-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER (ZOSTAVAX) / MERCK & CO. INC. 1411F / UNK UN / UN

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

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: (therapy unspecified) (therapy unspecified) (therapy unspecified)
Current Illness:
Preexisting Conditions: MEDICAL HISTORY: Hysterectomy CONCURRENT CONDITIONS: Shingles, Cholesterol, Penicillin allergy, Type II diabetes mellitus, Hypertension
Allergies:
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.


Changed on 6/14/2018

VAERS ID: 270421 Before After
VAERS Form:1
Age:62.0
Sex:Female
Location:California
Vaccinated:2006-12-01
Onset:2007-01-05
Submitted:2007-01-11
Entered:2007-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER (ZOSTAVAX) / MERCK & CO. INC. 1411F / UNK UN / UN

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

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: (therapy unspecified) (therapy unspecified) (therapy unspecified)
Current Illness:
Preexisting Conditions: MEDICAL HISTORY: Hysterectomy CONCURRENT CONDITIONS: Shingles, Cholesterol, Penicillin allergy, Type II diabetes mellitus, Hypertension
Allergies:
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.


Changed on 8/14/2018

VAERS ID: 270421 Before After
VAERS Form:1
Age:62.0
Sex:Female
Location:California
Vaccinated:2006-12-01
Onset:2007-01-05
Submitted:2007-01-11
Entered:2007-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER (ZOSTAVAX) / MERCK & CO. INC. 1411F / UNK UN / UN

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

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: (therapy unspecified) (therapy unspecified) (therapy unspecified)
Current Illness:
Preexisting Conditions: MEDICAL HISTORY: Hysterectomy CONCURRENT CONDITIONS: Shingles, Cholesterol, Penicillin allergy, Type II diabetes mellitus, Hypertension
Allergies:
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.


Changed on 9/14/2018

VAERS ID: 270421 Before After
VAERS Form:1
Age:62.0
Sex:Female
Location:California
Vaccinated:2006-12-01
Onset:2007-01-05
Submitted:2007-01-11
Entered:2007-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER (ZOSTAVAX) / MERCK & CO. INC. 1411F / UNK UN / UN

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

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: (therapy unspecified) (therapy unspecified) (therapy unspecified)
Current Illness:
Preexisting Conditions: MEDICAL HISTORY: Hysterectomy CONCURRENT CONDITIONS: Shingles, Cholesterol, Penicillin allergy, Type II diabetes mellitus, Hypertension
Allergies:
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.


Changed on 10/14/2018

VAERS ID: 270421 Before After
VAERS Form:1
Age:62.0
Sex:Female
Location:California
Vaccinated:2006-12-01
Onset:2007-01-05
Submitted:2007-01-11
Entered:2007-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER (ZOSTAVAX) / MERCK & CO. INC. 1411F / UNK UN / UN

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

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: (therapy unspecified) (therapy unspecified) (therapy unspecified)
Current Illness:
Preexisting Conditions: MEDICAL HISTORY: Hysterectomy CONCURRENT CONDITIONS: Shingles, Cholesterol, Penicillin allergy, Type II diabetes mellitus, Hypertension
Allergies:
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.


Changed on 8/14/2019

VAERS ID: 270421 Before After
VAERS Form:1
Age:62.0
Sex:Female
Location:California
Vaccinated:2006-12-01
Onset:2007-01-05
Submitted:2007-01-11
Entered:2007-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER (ZOSTAVAX) ZOSTER LIVE (ZOSTAVAX) / MERCK & CO. INC. 1411F / UNK UN / UN

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

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: (therapy unspecified) (therapy unspecified) (therapy unspecified)
Current Illness:
Preexisting Conditions: MEDICAL HISTORY: Hysterectomy CONCURRENT CONDITIONS: Shingles, Cholesterol, Penicillin allergy, Type II diabetes mellitus, Hypertension
Allergies:
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.


Changed on 12/24/2020

VAERS ID: 270421 Before After
VAERS Form:1
Age:62.0
Sex:Female
Location:California
Vaccinated:2006-12-01
Onset:2007-01-05
Submitted:2007-01-11
Entered:2007-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER LIVE (ZOSTAVAX) / MERCK & CO. INC. 1411F / UNK UN / UN

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

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: (therapy unspecified) (therapy unspecified) (therapy unspecified)
Current Illness:
Preexisting Conditions: MEDICAL HISTORY: Hysterectomy CONCURRENT CONDITIONS: Shingles, Cholesterol, Penicillin allergy, Type II diabetes mellitus, Hypertension
Allergies:
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.


Changed on 12/30/2020

VAERS ID: 270421 Before After
VAERS Form:1
Age:62.0
Sex:Female
Location:California
Vaccinated:2006-12-01
Onset:2007-01-05
Submitted:2007-01-11
Entered:2007-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER LIVE (ZOSTAVAX) / MERCK & CO. INC. 1411F / UNK UN / UN

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

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: (therapy unspecified) (therapy unspecified) (therapy unspecified)
Current Illness:
Preexisting Conditions: MEDICAL HISTORY: Hysterectomy CONCURRENT CONDITIONS: Shingles, Cholesterol, Penicillin allergy, Type II diabetes mellitus, Hypertension
Allergies:
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.


Changed on 5/7/2021

VAERS ID: 270421 Before After
VAERS Form:1
Age:62.0
Sex:Female
Location:California
Vaccinated:2006-12-01
Onset:2007-01-05
Submitted:2007-01-11
Entered:2007-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER LIVE (ZOSTAVAX) / MERCK & CO. INC. 1411F / UNK UN / UN

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

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: (therapy unspecified) (therapy unspecified) (therapy unspecified)
Current Illness:
Preexisting Conditions: MEDICAL HISTORY: Hysterectomy CONCURRENT CONDITIONS: Shingles, Cholesterol, Penicillin allergy, Type II diabetes mellitus, Hypertension
Allergies:
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.


Changed on 5/21/2021

VAERS ID: 270421 Before After
VAERS Form:1
Age:62.0
Sex:Female
Location:California
Vaccinated:2006-12-01
Onset:2007-01-05
Submitted:2007-01-11
Entered:2007-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER LIVE (ZOSTAVAX) / MERCK & CO. INC. 1411F / UNK UN / UN

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

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: (therapy unspecified) (therapy unspecified) (therapy unspecified)
Current Illness:
Preexisting Conditions: MEDICAL HISTORY: Hysterectomy CONCURRENT CONDITIONS: Shingles, Cholesterol, Penicillin allergy, Type II diabetes mellitus, Hypertension
Allergies:
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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