Age: 62.0
Sex: F
Vaccine: VARZOS, VARZOS
Symptoms: Body temperature decreased, Herpes zoster, Pain, Pruritus, Rash papular
Clinical narrative: Information has been received from a nurse practitioner concerning a female patient with no pertinent medical history, who on approximately 16-FEB-2009, "about one week ago" was vaccinated with a dose of ZOSTER vaccine live (Oka/Merck).  On an unspecified date, the patient developed a painful papular-vesicular rash on her right abdomen radiating to the right flank area.  The patient had scheduled an appointment in the office of 23-FEB-2009.  There were no laboratory or diagnostic tests performed, the nurse practitioner was interested in collecting isolates from the lesions for Polymerase Chain Reaction testing.  At the time of reporting, the patient had not recovered.  Follow up information has been received from a completed questionnaire by a nurse practitioner.  It was reported that the 62 year old female patient with hypertension, hypercholesterolaemia, arteriosclerotic heart disease, asthma, gastrooesophageal reflux disease, shellfish allergy, diabetes mellitus maturity onset and degenerative joint disease and a history of stent placement who on 17-FEB-2009 was vaccinated with a dose of ZOSTER vaccine live (Oka/Merck) (Lot # 663673/1710X).  Concomitant therapy included AVANDIA, vitamin B complex vitamins (unspecified), potassium (unspecified), DYAZIDE, metformin, LIPITOR, TOPROL XL TABLETS, CAPOTEN, LOPRESSOR and cyanocobalamin.  On 21-FEB-2009, the patient developed a papulo-vesular rash with 8 papular- vesicular rash lesions on her right abdomen to flank to vertebral line, the patient had a maximum temperature of 97.  The patient also had HERPES ZOSTER DERMATOMA T 11.  At the time of reporting, the patient had recovered.  Additional information has been requested. Follow up information has been received from an advanced nurse practitioner on 09-MAR-2009.  It was reproted that the patient with no illness at the time of vaccination, on 17-FEB-2009 was vaccinated subcutaneously in the left deltoid area with a dose of ZOSTAVAX (Merck) (Lot # 663673/1710X) at 11:00 a.m.  On 21-FEB-2009, 4 days after ZOSTAVAX (Merck) vaccine, the patient woke up with itchy lesions on right flank which continued the next 24 hours to extend across right abdomen and right back to midline.  Papulovesicular lesions that were pruritic and painful became more painful next day and the patient came to the physician's office on 23-FEB-2009.  A swab from lesion was sent for testing.  At the time of reporting, the patient had not recovered (previously reported as recovered).  Follow up information has been received on 13-MAR-2009.  The patient was enrolled in the Varicella Zoster Virus Identification Program to identify if VZV was present and if it was present to identify if it was associated wit hthe wild-type (WT) VZV strain or with the OKA/Merck vaccine VZV strain.  The sample of the lesion was collected on 23-FEB-2009.  The sample was taken from a papulovesicular lesion from the abdomen.  On 12-MAR-2009, the PCR results for the specimen identified the presence of WILD TYPE STRAIN VZV.  Additional information has been requested.