|
VAERS ID: |
259589 (history) |
Form: |
Version 1.0 |
Age: |
62.0 |
Sex: |
Female |
Location: |
Missouri |
Vaccinated: | 2006-06-16 |
Onset: | 2006-06-18 |
Days after vaccination: | 2 |
Submitted: |
2006-07-10 |
Days after onset: | 22 |
Entered: |
2006-07-17 |
Days after submission: | 7 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
VARZOS: ZOSTER LIVE (ZOSTAVAX) / MERCK & CO. INC. |
- / UNK |
UN / SC |
Administered by: Other Purchased by: Other Symptoms: Glossitis SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Other Medications: NONE Current Illness: Preexisting Conditions: Medical history: Shingles Allergies: Diagnostic Lab Data: NONE CDC Split Type: WAES0606USA05500
Write-up: Information has been received from a pharmacist concerning a 62 year old female with no known allergies and a history of shingles who on 16-JUN-2006 was vaccinated SC with a dose of varicella-zoster virus vaccine live. There was no concomitant medication. On 18-JUN-2006, two days after vaccination, the patient developed a swollen tongue. The patient reported that when she woke up in the morning her tongue was swollen and she even had teeth impression on her tongue. The patient was scheduled to see her doctor on 28-JUN-2006 since she was still experiencing the problem. She had no problems breathing and eating. As of 28-JUN-2006, it was reported that the patient was recovering. No product quality complaint was involved. Additional information has been requested. This is in follow-up to report(s) previously submitted on 7/10/2006. Additional information from the pharmacist indicated that the patient''s condition has resolved and the patient is fine. The physician''s office called the pharmacist to report that the patient''s swollen tongue was not due to ZOSTAVAX (Oka/Merck) but due to the patient''s new toothpaste. No further information is available. |
|
VAERS ID: |
261580 (history) |
Form: |
Version 1.0 |
Age: |
67.0 |
Sex: |
Male |
Location: |
California |
Vaccinated: | 2006-07-08 |
Onset: | 2006-07-13 |
Days after vaccination: | 5 |
Submitted: |
2006-08-10 |
Days after onset: | 28 |
Entered: |
2006-08-15 |
Days after submission: | 5 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
VARZOS: ZOSTER LIVE (ZOSTAVAX) / MERCK & CO. INC. |
0621F / 1 |
LA / SC |
Administered by: Private Purchased by: Private Symptoms: Myalgia,
Pyrexia SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Other Medications: HYTRIN, testosterone Current Illness: Blood pressure high, enlarged prostate Preexisting Conditions: Allergies: Diagnostic Lab Data: Body temperature, 07/15/2006, 101 F CDC Split Type: WAES0607USA03744
Write-up: Information has been received from a 67 year old male consumer with high blood pressure and enlarged prostate who on 08-JUL-2006 was vaccinated SC in the left arm with a 0.5 ml dose of varicella-zoster virus vaccine live (Merck). Concomitant therapy included Terazosin hydrochloride (HYTRIN) and testosterone gel. On 13-JUL-2006 the patient experienced soreness in the left arm where the shot was administered. By 14-JUL-2006 the patient had severe muscle pain in the left arm. Aspirin was taken and alleviated the pain. On 15-JUL-2006 the patient developed a fever of 101 degrees. The fever dissipated by the morning of 16-JUL-2006. Unspecified medical attention was sought. The patient recovered on 17-JUL-2006. There was no product quality complaint involved. Additional information has been requested. Follow up - information received from the physician indicated that he did not have any information from the patient about any adverse reactions. Additional information in not expected. |
|
VAERS ID: |
261581 (history) |
Form: |
Version 1.0 |
Age: |
75.0 |
Sex: |
Male |
Location: |
California |
Vaccinated: | 2006-06-20 |
Onset: | 2006-07-18 |
Days after vaccination: | 28 |
Submitted: |
2006-08-10 |
Days after onset: | 23 |
Entered: |
2006-08-15 |
Days after submission: | 5 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
VARZOS: ZOSTER LIVE (ZOSTAVAX) / MERCK & CO. INC. |
- / UNK |
- / - |
Administered by: Other Purchased by: Other Symptoms: Influenza like illness,
Pulmonary congestion,
Pyrexia SMQs:, Cardiac failure (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Other Medications: PROSCAR, SYNTHROID, PRAVACHOL, BENEMID Current Illness: Preexisting Conditions: Medical history: Shingles Allergies: Diagnostic Lab Data: NONE CDC Split Type: WAES0607USA05370
Write-up: Information has been received from a 75 year old male consumer with a history of shingles "once or twice many years ago" and no other reported allergies or history who approximately 20-JUN-2006 was vaccinated with a dose of varicella-zoster virus vaccine live. Concomitant therapy included finasteride (MSD), pravastatin Na (PRAVACHOL), levothyroxine Na (SYNTHROID) and probenecid (BENEMID). About 4 weeks after vaccination, on approximately 18-JUL-2006, the patient developed a high fever and felt very sick with chest congestion and flu-like symptoms. He said was seen by his doctor and the doctor''s diagnosis was that he had a bacterial infection. Subsequently, the patient recovered. There was no product quality complaint involved. Additional information has been requested. |
|
VAERS ID: |
261665 (history) |
Form: |
Version 1.0 |
Age: |
71.0 |
Sex: |
Male |
Location: |
Michigan |
Vaccinated: | 2006-07-11 |
Onset: | 2006-07-27 |
Days after vaccination: | 16 |
Submitted: |
2006-08-14 |
Days after onset: | 18 |
Entered: |
2006-08-17 |
Days after submission: | 3 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
VARZOS: ZOSTER LIVE (ZOSTAVAX) / MERCK & CO. INC. |
- / UNK |
UN / - |
Administered by: Other Purchased by: Other Symptoms: Dyspnoea,
Heart rate increased,
Nervousness,
Tachycardia SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypoglycaemia (broad), Dehydration (broad)
Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Other Medications: Zetia Current Illness: Preexisting Conditions: Hypercholesterolaemia, Joint disorder Allergies: Diagnostic Lab Data: Electrocardiogram 7/27/06 HR 110-120 CDC Split Type: WAES0608USA01046
Write-up: Information has been received from a 71 year old retired physician with no known allergies and hypercholesterolaemia who on 7/11/06 was vaccinated in the left arm with a dose of varicella zoster virus vaccine live. Concomitant therapy included ezetimibe. A couple weeks after vaccination on 7/27/06, the pt experienced tachycardia that was persisted. He was seen by a two cardiologists and had an echocardiogram done which did not show anything. Two EKGs were done and his HR was 110-120. He also reported that he was having a little shortness of breath occasionally,but didn''t think, it was related to vaccination. He did not have any other cardiovascular problems. The physician reported his sustained tachycardia to be potentially life threatening and disabling because he wasn''t sure if his tachycardia was self limiting and temporary or would cause additional problems. He reported that he was nervous when his HR was high for 2-3 weeks. His cardiologist recommended unspecified medication, however the physician refused to take any medication. As of 8/10/06 the physician reported that his heartrate was gradually slowing down, it was 90-100 which was better than before but still not back to normal. Four months prior to vaccination the pt scheduled knee surgery for 8/22/06. He explained that he would proceed with the surgery as long as his heart rate was back to normal. Additional information has been requested. |
|
VAERS ID: |
261784 (history) |
Form: |
Version 1.0 |
Age: |
82.0 |
Sex: |
Male |
Location: |
Virginia |
Vaccinated: | 2006-07-31 |
Onset: | 2006-07-31 |
Days after vaccination: | 0 |
Submitted: |
2006-08-04 |
Days after onset: | 4 |
Entered: |
2006-08-18 |
Days after submission: | 14 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
VARZOS: ZOSTER LIVE (ZOSTAVAX) / MERCK & CO. INC. |
0621F / 2 |
LA / - |
Administered by: Private Purchased by: Private Symptoms: Rash SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Other Medications: HCTZ, ASA, Proscar, Lorazepam, Fosamax, Calcium, vitamin D, Xalectan, Prilosec Current Illness: Spinal stenosis Preexisting Conditions: Spinal Stenosis, Osteoporosis, Hypertension, BPH, Lumbar spinal stenosis Allergies: Diagnostic Lab Data: CDC Split Type:
Write-up: Received Zostavax 7/31/06 developed rash along left T/O dermatome, entirely within 24 hours, seen 8/3/06 rash was starting to fade. |
|
VAERS ID: |
262241 (history) |
Form: |
Version 1.0 |
Age: |
84.0 |
Sex: |
Female |
Location: |
Arizona |
Vaccinated: | 2006-08-25 |
Onset: | 2006-08-26 |
Days after vaccination: | 1 |
Submitted: |
2006-08-28 |
Days after onset: | 2 |
Entered: |
2006-08-29 |
Days after submission: | 1 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
VARZOS: ZOSTER LIVE (ZOSTAVAX) / MERCK & CO. INC. |
0722F / UNK |
LA / SC |
Administered by: Private Purchased by: Unknown Symptoms: Feeling hot,
Injection site erythema,
Tenderness SMQs:, Extravasation events (injections, infusions and implants) (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Other Medications: Lysine, Calcium Current Illness: NONE Preexisting Conditions: NONE Allergies: Diagnostic Lab Data: NONE CDC Split Type:
Write-up: Local redness, tenderness and heat to LUE at site of administration. Increasing in size. |
|
VAERS ID: |
262263 (history) |
Form: |
Version 1.0 |
Age: |
63.0 |
Sex: |
Female |
Location: |
Pennsylvania |
Vaccinated: | 2006-08-23 |
Onset: | 2006-08-24 |
Days after vaccination: | 1 |
Submitted: |
2006-08-24 |
Days after onset: | 0 |
Entered: |
2006-08-29 |
Days after submission: | 5 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
VARZOS: ZOSTER LIVE (ZOSTAVAX) / MERCK & CO. INC. |
0621F / 1 |
LA / SC |
Administered by: Other Purchased by: Other Symptoms: Erythema,
Pain,
Skin nodule SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Other Medications: Current Illness: NONE Preexisting Conditions: NONE Allergies: Diagnostic Lab Data: NONE CDC Split Type:
Write-up: Lump on right upper arm approx 2"x2" round. Red area approx 1 1/2x 1 1/2. Initially had pain but is gone now. |
|
VAERS ID: |
262354 (history) |
Form: |
Version 1.0 |
Age: |
64.0 |
Sex: |
Female |
Location: |
Arkansas |
Vaccinated: | 2006-08-23 |
Onset: | 2006-08-26 |
Days after vaccination: | 3 |
Submitted: |
2006-08-30 |
Days after onset: | 4 |
Entered: |
2006-08-30 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
VARZOS: ZOSTER LIVE (ZOSTAVAX) / MERCK & CO. INC. |
0622F / 1 |
RA / SC |
Administered by: Unknown Purchased by: Unknown Symptoms: Arthralgia,
Herpes simplex,
Malaise,
Pyrexia,
Rash erythematous SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Arthritis (broad), 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? No
Previous Vaccinations: Other Medications: Premarin, Benicar/HCTZ Current Illness: none Preexisting Conditions: History of hypothyroidism, hypertension, anemia, hypokalemia, esophogeal cancer, colon cancer and fatigue. Allergies: Diagnostic Lab Data: CBC and Basic Metabolic Panel drawn at office visit today. CDC Split Type:
Write-up: Cold Sores on lips within 24 hours of vaccination, generalized arthralgia, elevated temperature, general ill feeling 3-4 days post vaccination, raised rash on right shoulder 7 days post vaccination. |
|
VAERS ID: |
262456 (history) |
Form: |
Version 1.0 |
Age: |
71.0 |
Sex: |
Female |
Location: |
Alaska |
Vaccinated: | 2006-07-19 |
Onset: | 2006-07-19 |
Days after vaccination: | 0 |
Submitted: |
2006-08-28 |
Days after onset: | 40 |
Entered: |
2006-09-01 |
Days after submission: | 4 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
VARZOS: ZOSTER LIVE (ZOSTAVAX) / MERCK & CO. INC. |
0621F / UNK |
- / IM |
Administered by: Other Purchased by: Other Symptoms: Blister,
Chest pain,
Malaise,
Nasal congestion,
Rash SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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? No
Previous Vaccinations: Other Medications: NONE Current Illness: Preexisting Conditions: Cancer; neoplasm; chemotherapy; shingles; penicillin allergy; drug hypersensitivity. Allergies: Diagnostic Lab Data: CDC Split Type: WAES0608USA03617
Write-up: Information has been received from a health professional concerning a 71 yr old female with penicillin and morphine allergies and a history of shingles who on 19Jul06 was vaccinated IM with a 0.65 ml dose of varicella zoster virus vaccine live (lot 65295/0621F). There was no concomitant medication. On 26Jul06 the pt experienced a rash with little tiny blisters. She also had a congested chest and chest pain associated with the rash. The rash would come and go and was worse in the afternoon. The pt was treated with triamcinolone cream and diphenhydramine hydrochloride (Benadryl). The pt reported that she was very sick, but was feeling better. The pt reported that she was seen by another physician who noted that she had a rash inside her esophagus, chest and lung. The week of 14Aug06 the pt was fine, but on 23Aug06 she broke out in blisters. The pt had been taking diphenhydramine hydrochloride (Benadryl) 25mg TID. On 24Aug06 the pt was going to take two 25mg tablets of diphenhydramine hydrochloride (Benadryl) since her rash is always worse in the afternoon. The nurse reported that the pt had a history of cancer and had a tumor in her head a year ago, in 2005. The pt was in remission and was in between her chemotherapy treatments, with the last treatment in May 2006. At the time of the report, the pt had not yet recovered. There was no product quality complaint involved. The pt''s chest pain was considered to be an other important medical event (OMIC). Additional information has been requested. |
|
VAERS ID: |
262816 (history) |
Form: |
Version 1.0 |
Age: |
85.0 |
Sex: |
Female |
Location: |
Idaho |
Vaccinated: | 2006-08-24 |
Onset: | 2006-08-25 |
Days after vaccination: | 1 |
Submitted: |
2006-08-28 |
Days after onset: | 3 |
Entered: |
2006-09-11 |
Days after submission: | 14 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
VARZOS: ZOSTER LIVE (ZOSTAVAX) / MERCK & CO. INC. |
0621F / 1 |
LA / SC |
Administered by: Public Purchased by: Private Symptoms: Erythema,
Rash SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Other Medications: Coumadin, Attune, Phosomax, Topral Current Illness: Preexisting Conditions: High blood pressure, atrial fibrillation Allergies: Diagnostic Lab Data: CDC Split Type: ID06033
Write-up: Woke up next morning with 11 red spots on right thigh. August 25. On Aug 27 3 more red spots appeared on the same area on right thigh. No other symptoms. Referred to her Dr. |
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