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This is VAERS ID 293272

Case Details

VAERS ID:293272 (history)  Vaccinated:0000-00-00
Age:  Onset:0000-00-00
Gender:Male  Submitted:2007-10-15
Location:California  Entered:2007-10-16, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: hemoglobin levels dropped
CDC 'Split Type': WAES0710USA02741
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
TTOX: TETANUS TOXOID (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Haemoglobin decreased
SMQs:, Haematopoietic erythropenia (broad), Haemorrhage laboratory terms (broad)
Write-up: Information has been received from a physician concerning a male who, on an unspecified date, was vaccinated with a single dose of Zostavax (Oka/Merck). Vaccinations received on the same day included tetanus toxoid (manufacturer unknown) and influenza virus vaccine (unspecified) (manufacturer unknown). The physician reported that after receiving the vaccinations the patient''s hemoglobin levels dropped. The patient was sent to the hospital and admitted. There was no product quality complaint. Hemoglobin levels dropped was considered to be disabling. Additional information has been requested.

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