This is VAERS ID 423293
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| VAERS ID: | 423293 (history) | Vaccinated: | 2007-07-03 | | Age: | 12.0 | Onset: | 2011-01-11, Days after vaccination: 1288 | | Gender: | Female | Submitted: | 2011-05-12, Days after onset: 120 | | Location: | Texas | Entered: | 2011-05-18, Days after submission: 6 | |
| Life Threatening? No |
| Died? No |
| Permanent Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Previous Vaccinations: | | Other Medications: | | Current Illness: | | Preexisting Conditions: Unknown | | Diagnostic Lab Data: Unknown | | CDC 'Split Type': WAES1101USA03560 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | VARCEL: VARICELLA (VARIVAX) | MERCK & CO. INC. | | 1 | SC | UN | |
| Administered by: Private Purchased by: Private | Symptoms: Herpes zoster
SMQs:
| | Write-up: Information has been received from a registered pharmacist concerning her 12 year old daughter who on an unspecified date was vaccinated with the second dose of VARIVAX (Merck) (Lot # and expire date not reported), 0.5 ml, subcutaneously. Registered pharmacist stated that on an unspecified date, her daughter experienced shingles and added that her daughter''s shingles cleared up after she was administered acyclovir. The patient sought unspecified medical attention. Follow-up information was received from a physician concerning a female patient with no illness at the time of vaccination who on 03-JUL-2007 was vaccinated with the second dose of VARIVAX (Merck) (Lot # and expire date not reported), 0.5 ml, subcutaneously. Suspect therapy included the second dose of GARDASIL (Lot # and expire date not reported) administered on 27-JUL-2010. Concomitant therapy included the third dose of FLUVIRIN (Lot # and expire date not reported) administered on 22-AUG-2010. The physician stated that on 11-JAN-2011, the patient was diagnosed with shingles/Zoster. In 2011, the patient recovered. There were no laboratory diagnostics studies performed. The patient did not seek medical attention. Additional information is not expected. |
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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=423293
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