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| 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 | | FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) | UNKNOWN MANUFACTURER | | | UN | UN | | TTOX: TETANUS TOXOID (NO BRAND NAME) | UNKNOWN MANUFACTURER | | | UN | UN | | VARZOS: ZOSTER (ZOSTAVAX) | MERCK & CO. INC. | | | UN | UN | |
| 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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