Age: 62.0
Sex: F
Vaccine: VARZOS
Symptoms: Cardiovascular evaluation, Injection site erythema, Injection site vesicles, Injection site warmth, Local reaction
Clinical narrative: Information has been received from a registered pharmacist concerning a 62 year old female with diabetes, gastrooesophageal reflux disease (GERD), cardiac disorder, anxiety, gout, hypothyroidism, seasonal allergy and drug allergy to morphine, PHENERGAN, ZOLOFT, TRICOR and AMBIEN who on 04-MAY-2012 was vaccinated SC with a dose of ZOSTAVAX (Merck) (lot#: 671141/1276AA; Exp Date: 05-NOV-2012). Concomitant therapy included ezetimibe (+) simvastatin (MSD), omeprazole, isosorbide mononitrate, alprazolam, allopurinol, potassium chloride, levothyroxine Na, diltiazem HCL, bumetanide, spironolactone, TRADJENTA, warfarin, estropipate, verapamil, fexofenadine hydrochloride and glimepiride. On 15-MAY-2012 the patient developed a red, warm "with possibly a blister" at the site of injection. The patient sought medical attention by coming to the pharmacy. There was no lab diagnostics studies performed. At the time of report, the patient was not recovered. Follow up information has been received from the physician's assistant concerning the patient with no illness at time of vaccination and with chronic kidney disease (stage 3), atrial fibrillation, congestive heart failure, diabetes mellitus, hypercalcemia, glaucoma, coronary artery spasm, anemia, mitral regurgitation, hard of hearing, hyperlipidemia, allergic rhinitis, hypokalemia, upper respiratory tract infection, calf cramp, back pain, acute sinusitis, vaginal candidiasis, allergy to TESSALON, AVELOX, sulfa allergy and a history of cerebral vascular accident, mitral valve repair, craniotomy, bilateral breast biopsies, back surgery, coronary artery bypass single, hysterectomy abdominal, cardiac pacemaker insertion, and appendectomy. The physician's assistant reported that on approximately 07-MAY-2012 (previously reported as 15-MAY-2012), the patient experienced erythema, swelling and blistering at the injection site. The patient stated that she had a reaction of break out from shingles shot. The patient denied itching or pain. The patient stated area was improving. No fever to area. The patient had some small red patches on left deltoid that appeared a few days after getting the vaccine, no blisters, positive erythematous. The patient general status was feeling well, she did not have appetite loss. Skin: had new lesions and rash, itching and pain were not present. Respiratory: cough was not present. Cardiovascular: chest pain, palpitations, shortness of breath and swelling of extremities was not present. Musculoskeletal: pain was not present. Neurological: tingling was not present. The patient's body surface was 1.66, body mass index was 26.64, pain level was 0/10, temperature was 97.7 degrees F, pulse was 83 (regular), respiration was 18 (unloaded), oxygen saturation rate was 93% (room air), blood pressure was 98/58. The physical examination showed: General: mental status: alert, general appearance: not in acute distress, orientation: oriented X3, build and nutrition: well nourished and well developed, posture: normal posture, gait: normal, hydration: well hydrated, voice: normal. Integumentary: Positive erythematous, edematous small patches on left deltoid, no blisters, no TTP or hyper sensitivity, no fever to. Chest and lung exam: Inspection: chest wall: normal; shape: normal and symmetric; movements: symmetrical; accessory muscles: no use of accessory muscles in breathing. Auscultation: breath sounds: normal to auscultation bilaterally and clear; adventitious sounds: no adventitious sounds. Cardiovascular: Inspection: carotid artery, bilateral: inspection normal, jugular vein bilateral: inspection normal. Auscultation: rhythm: regular: heart sounds: S1 WNL and S2 WNL No S3; murmurs and other heart sounds: auscultation of the heart revealed no murmurs. Vaccine reaction: the area seemed to be just a local reaction, the patient was advised to just monitor closely and should resolve after a few days, give update if any changes. The patient started therapies with IMDUR, alprazolam and PROTONIX. On an unspecified date, the patient recovered. Additional information is not expected.