Age: 71.0
Sex: M
Vaccine: VARZOS, VARZOS
Symptoms: Arthralgia, Burning sensation, Discomfort, Laboratory test normal, Pain
Clinical narrative: Information has been received from a licensed vocational nurse concerning a 71 year old male with an allergy to penicillin who on 06-DEC-2007 was vaccinated subcutaneously with 0.65 ml of Zostavax (Oka/Merck) (lot # 656413/1477F).  There was no concomitant medication.  Post vaccination the patient experienced joint and burning pain.  The patient first experienced burning pain in his leg, then the pain traveled to his back, abdomen and forehead.  "The patient tried different types of creams, but nothing worked".  Unspecified diagnostic laboratory testing was performed, of which all the results were negative.  Unspecified medical attention was sought.  There was no product quality complaint.  At the time of reporting the patient had not yet recovered.  Additional information has been requested. 06/24/08 This is in follow-up to report(s) previously submitted on 3/26/2008. Follow up information was received from a nurse which included following sequence of events reported by the consumer: on 6 Dec 07 the patient was vaccinated with ZOSTAVAX. On DEC 7th and 8th the patient developed some mild flu like aches in various joints that lasted about two days. On 10 Dec 07 the patient reported experiencing some mild burning sensations on the surface of the rear of his thighs, which he described as "like a mild sunburn" except bathing had no effect, nor did heat or cold. The patient attributed it to "muscle burn" from exercise on new elliptical trainer. There were no eruptions, rash or redness present. The patient reported it was definitely a surface sensation, not a deep seated ache. The burning sensation on the back of thighs continued, but overall appeared to be declining in effect. An over the counter preparation "Tiger Balm" was tried without relief. It was noted that the patient did not experience any itching, and there was no compulsion to scratch or rub, it was described as a pure, but mild burn. On 21 DEC 2007 it was noted that the burning sensation had left the thighs but was now present on the abdomen, mostly in the upper left quadrant, and on the mid-back, and lower buttocks. It was reported to also be present on the forehead, right side extending from the midline of the forehead and back around to the right ear and several inches up beyond the hairline and down to the eyebrow. No eruptions, rash or redness were present. On 27 Dec 07 the patient was seen by a physician regarding the sensation that was somewhere between a tingle and mild sunburn. It was noted that the patient presented in a well developed, well nourished state with no acute distress. Upon physical examination no eruptions, rash or redness were noted. Diagnostic laboratory studies performed included: Hepatic Function Panel, CBC Diff, Sedimentation Rate Automated and CPK, of which the results were all normal. An OTC sunburn preparation with a topical anesthetic was recommended. The patient received no relief with sunburn preparations. On 31 DEC 2007 the patient reported that there seemed to be some localization of the sensations to a palm sized patch on his mid back and upper left quadrant of my abdomen (as well as the palm sized patch on the forehead). The patient reported taking two aspirin at bedtime and now sleeps undisturbed through the night. On 03 Jan 08-"near the end of the fourth week", symptoms were gone from the back of his legs and buttocks, and had been reduced on abdomen and mid back to two small nuisance level patches. The sensitive burning area on the right side of the forehead had grown to include about half of the scalp on the right side: extending from just above the right ear to the apex the head on one axis, and from just above the right eyebrow to just past the center point of the head on the other axis. The scalp and forehead area seem substanially more sensitive to touch than any of the other places were. On 07 JAN 2008 it was noted that all sensitive places were gone from the abdomen and back, leaving only a patch on the head, and that too has changed. The sensitivity had left most the forehead and migrated up into the scalp, and was now limited to an area from the right ear to the crown of the head, and behind the right ear. At the time of reporting it was noted that the level of sensitivity was such as to make brushing the hair moderately uncomfortable. The patient described the sensation as an odd feeling, not truly painful, just uncomfortable. Additional information has been requested.