Age: 55.0
Sex: F
Vaccine: VARCEL
Symptoms: Back pain, Body temperature increased, Injection site cellulitis, Injection site erythema, Injection site induration
Clinical narrative: EE presented to the Employee Health clinic on 6/3/19 @ 3:44 pm to receive the varicella vaccine since she reported on 5/31/19 that she never had the chickenpox disease and her varicella IgG titer was negative for varicella.  Precautions/warnings/VIS reviewed and consent signed to receive the vaccine.  the employee reported that she has not have any reactions to previous vaccines, but does not like taking the flu vaccine because it makes her feel sick.  Varivax 0.5mL administered subcutaneously to posterior of left upper arm per standard protocol.  On 6/18/19, the employee presented back to the Employee Health Clinic with complaint of a localized reaction of the left arm where the varicella vaccine was administered.  The employee?s left upper arm was swollen, red, warm to touch, hard, and a noted pustule at injection site.  The employee?s temperature was 99.0.   The employee reported that she first noticed a localized reaction the morning following the vaccination and on Wednesday 6/5/19, she noticed a knot at the injection site.  On 6/17/19, the employee noticed that she did not feel well at all, was achy, and noticed the above symptoms to her arm were a little worse.  The employee also reported that as the day progressed on 6/18/19, she began to feel worse and the localized reaction worsened even more.  Upon presenting to the Employee Health Clinic as described, the employee was referred to a nearby Urgent Care on 6/18/19 where she was given a prescription of oral Bactrim and reports that she was told she had cellulitis of the upper left arm.  The employee was advised that if she was still running an elevated temperature the next day, that she should remain home.  Per telephone call with the employee on 6/19/19, she stated that she did not really feel any better, but wanted to try to go back to work the next day since she was a brand new employee.  The employee was referred and seen in follow up with an Occupational Health Care physician at Medical Center location.  On 6/20/19, the employee and the Occupational Physician reported that the employee had elevated temperature of 101 ? 102 degrees orally and that her face, back, and arms now had multiple pustules.  Per history of events and symptoms, the employee was diagnosed with chickenpox by the physician.   The employee was not returned to work.  The employee had a follow up with the Occupational Health Care physician on Monday 6/24/19.  The physician, reported to EH nurse that the employee had many more pustules covering her back, face, arms, and still running elevated temperature of 102 now.  A Varicella IgM was drawn, the result is still pending per this report.  Per telephone conversation with the employee later in the afternoon on 6/24/19, the employee stated that she was having a lot of back pain and found it difficult to sleep and that her temperature had gotten as high as 104 degrees.  The Employee Health Medical Director, was notified of employee?s worsening condition and the decision was made to advise the employee to go to the emergency room.   The employee went to the Hospital.  The employee remains hospitalized at Hospital and per employee report, is receiving IV antivirals.   Please note that on Question #23 - the response is unknown, because the employee reported that she does not like to get flu vaccines because they make her feel sick".  I am not sure if that is considered a reaction or not, therefore, it is answered 'unknown".