Age: 69.0
Sex: M
Vaccine: VARZOS
Symptoms: Rash vesicular, Skin irritation
Clinical narrative: Information has been received from a 70 year old male patient with no pertinent medical history and no drug reaction or allergies who on 06-JAN-2011 was vaccinated SQ with a 0.65ml dose of ZOSTAVAX (Merck) (lot # not reported). Concomitant therapy included vitamins (unspecified), calcium (unspecified), iron (unspecified), omega-3 marine triglycerides and loratadine (MSD). The patient stated that he received ZOSTAVAX (Merck) on 06-JAN-2011 and thought "he couldn't get shingles". On 11-AUG-2011, about a week and half ago, he developed a bad case of shingles. It started with terrible pain in his back, right shoulder and chest. He had a hard time breathing and thought he was having a heart attack. He broke out in a rash, experienced pain and dizziness. He noted that he got the ZOSTAVAX (Merck) at an unspecified pharmacy and not at his physician's office. The patient contacted physician to seek medical attention. No lab diagnostics studies were performed. The patient was treated with VALTREX and NORCO. At the time of the report, the patient had not recovered. Follow-up information was received from a physician concerning the 70 year old male with no drug and food allergies and a history of chickenpox as a child but not remember when who on 06-JAN-2011 was vaccinated with a dose of ZOSTAVAX (Merck). Concomitant therapy included vitamin D (unspecified), calcium (unspecified), iron (unspecified), omega-3 marine triglycerides, CLARITIN, OSTEO-BI-FLEX and NAPROSYN. On 11-AUG-2011, the patient developed typical shingles rash, it was more severe than usual on back, left arm and chest. And it was pain in upper back. The patient was enrolled in the Varicella Zoster Virus Identification Program to identify if VZV is present and if it is present, to identify if it is associated with the wild-type (WT) VZV strain or with the Merck vaccine strain. No lesion with vesicle or scab that was able to be capture. At the time of the report, the patient was still having pain and the rash was resolving. The physician was worry about post herpes varicella. Follow up information was received on 13-SEP-2011 from a physician and medical records concerning a 70 year old male (193 pounds, 63.5 inches) with no known allergies, lumbar degenerative disc disease, spinal stenosis, iron deficiency versus inactive Crohn's disease and history of bilateral shoulder surgeries and hip replacement. The patient was vaccinated with a dose of ZOSTAVAX (Merck) at a pharmacy on 06-JAN-2011. On 06-AUG-2011 the patient developed pain in his upper back along his scapula that radiated around to his chest. The patient had been lifting furniture and thought he had pulled something but pain persisted. On 08-AUG-2011 the patient took amoxicillin as prophylaxis for dental work and initially attributed the rash to the amoxicillin. The patient noticed a rash on his chest and back that spread to his arms. On 11-AUG-2011, the patient was examined and the physician reported an obvious shingles rash in the middle of his back that spread out two inches. There were typical vesicular lesions that were drying up on the back, around his chest and down the inside of his right arm in the T2 Dermatome. The physician assessment was marked herpes zoster despite shingles vaccine. The patient was treated with VALTREX, one gram three times a day for seven days and NORCO 5/325mg for pain. The physician also reported that the patient had been out west for five weeks and started to get a rash over the outside of his right ankle, that had some had burs in. The physician felt that the circular excoriated rash over right ankle was an allergic reaction which the patient had been scratching and physician ordered KENALOG bid. On 01-SEP-2011, the patient was examined and the physician reported he had no vesicles or scab, therefore a culture was not obtained. The patient continued with significant radicular pain. The physician's assessment was persistent pain from herpes zoster with lesions drying up. The patient reported that NORCO had not helped the pain. The patient was started on NEURONTIN 300mg at night and could increase to 300mg tid. The patient complained of pain outside of right hip and lower back. The patient was advised to apply heat and obtain appointment with the orthopedic surgeon who did his surgery. It was reported there was no rash at the injection site within forty two days of the vaccination nor was there any recent exposure to chicken pox or herpes zoster. Physician reported, typical shingles rash T2 Dermatome was an other important medical event. At the time of this report the rash is resolving and the patient continued with pain. All available medical records will be provided upon request. Additional information has been request.