Age: 66.0
Sex: F
Vaccine: VARZOS
Symptoms: Herpes zoster, Rash, Varicella zoster serology negative
Clinical narrative: Information has been received from a certified medical assistant concerning a 66 year old female patient with no known drug reactions/allergies and with asthma who on 29-JAN-2009 was vaccinated subcutaneously into the right arm with a 0.65 ml dose of ZOSTAVAX (Oka/Merck) (Lot # 662996/1618X).  Concomitant therapy included ALBUTEROL inhaler and ADVAIR.  On 31-JAN-2009 the medical assistant reported that the patient was diagnosed with shingles after vaccination.  The patient presented to the office with a rash on her right cheek and forehead.  At the time of reporting the patient had not recovered.  In follow up information received via medical record the physician reported that the patient with allergic rhinitis, urticaria, hyperlipidaemia, gastrooesophageal reflux disease (GERD), asthma, rhinitis allergic, urticaria, hyperlipidaemia, conjunctivitis allergic, plantar fasciitis, sinusitis and a history of appendectomy, breast biopsy in 1971, tubal ligation, left heel surgery, upper respiratory tract infection, chest pain, diarrhoea infectious, duodenitis, low back strain, hiatus hernia, dysphagia, trochanteric bursitis, and the patient stopped smoking in 1971.   On 03-FEB-2009 the patient went to the doctor's office complaint of a rash that presented from 31-JAN-2009 to 01-FEB-2009, and had been accompanied by redness and being slightly raised on the skin after vaccination with ZOSTAVAX (Oka/Merck) (Lot # 662996/1618X).  The affected area was the right cheek, and also stated that there was a sensitive area around the hair line, and right ear pain also.  The patient was not sure of any topicals to use, or what to take for pain.  It was noted that there was no inflammatory effect at injection site.  The physician reported that patient had chickenpox as a child.  On records from 10-FEB-2009 the physician reported that Previous immunization included: DTAP (manufacturer unknown) administered on 18-MAY-2001, FLUZONE and PNEUMOVAX administered on 10-NOV-2008 at 4:26 and 4:28 PM respectively.  Concomitant therapy included ADVAIR DISKUS, ASPERCREAME, CENTRUM SILVER), calcium cabonate (+) cholecalciferol, cromolyn sodium, triamcinolone acetonide, PROMETHAZINE W/DM, ibuprofen and azithromycin.  The patient was normal at the physical exam and mental status.  The patient presented shingles in distribution of the right facial nerve mandibular branch.  The patient was given VALTREX as a treatment of shingles.  At the time of the report the patient has not recovered.  On 09-FEB-2009, the patient was seen in the office.  The patient was feeling alright.  She still had some pain in the right facial area and across the scalp on the right side.  Noted that she had pain that had responded ok to ADVIL and she felt that she needed no additional medications at that time.  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) VAV strain or with the OKA/Merck vaccine VZV strain.  The sample of the lesion was collected on 09-FEB-2009 and sent on 11-FEB-2009.  The sample was taken from a vesicular lesion.  The PCR results for the specimen from vesicular lesion was negative (no VZV identified).  Additional information has been requested.