Age: 60.0
Sex: F
Vaccine: VARZOS
Symptoms: Rash vesicular, Varicella virus test negative
Clinical narrative: Information has been received from a registered nurse concerning an approximately 61 year old female patient who in June 2009, was vaccinated with a dose of ZOSTAVAX (Merck) (lot # 664277/0367Y, exp. 03-OCT-2010). In September 2009, the patient developed a rash on her buttocks. The nurse stated that the patient was still having the same rash occur. The rash was the patient's right buttock and it became bubbly, itchy and painful. The rash tended to go away but then always came back. The patient spoke to a physician. The nurse stated the physician did not think this was related to the vaccine but the patient felt it was related. At the time of the report, the patient had not recovered. Follow up information was received from a physician assistant concerning the patient with latex allergy, hypertension, high cholesterol, thyroid, reflux and diverticulosis and a history of chickenpox during childhood was vaccinated with a dose of ZOSTAVAX (Merck) (lot # 664277/0367Y) on 17-JUN-2009 in the deltoid of her left arm. Concomitant therapy included NORVASC, CRESTOR, ibuprofen, aspirin and CALTRATE + D. A rash did not occur at the site of injection or elsewhere within 42 days of the vaccination. In December 2009 the patient reported that she had experienced 4 episodes of a rash post vaccination. It had never been evaluated in office until 01-APR-2010 outbreak. It was stated that the rash had been traveling down spine for a year prior to that visit. The maximum temperature was 98.8. It continued itching every few weeks traveling from the right thoracic region down the back. The rash type was vesicular. The number of lesions was a patch with several vesicular lesions punched together. Distribution of lesions was along the right spinal root had just jumped to left buttock. Dermatome started about T4-T5 area according to the patient on several occasions as been on S4/S5 area when evaluated. Pain was reported as 0-1-2. There was no photo taken. There was no a direct fluorescent antibody done. The physician had reported that it was a vesicular rash, herpes zoster. 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) VZV strain or with the Merck vaccine strain. A lesion sample was collected on 21-JUL-2010. The sample was taken from a vesicle. Follow up information has been received concerning that on 21-JUL-2010 a specimen was taken from a lesion on the patient's left buttock. On 22-JUL-2010, the specimen arrived at the laboratory. VZA DNA was not amplified and B-globin DNA was amplified. The PCR result from the adequate specimen was no VZA identified-negative. At the time of the report, the patient was recovering. Follow up information was received from the registered nurse concerning the 61 year old female with latex allergy who at 09:16 on 17-JUN-2009 was vaccinated with the first dose of ZOSTAVAX (Merck) (lot # 664277/0367Y) into her left arm. On 01-APR-2010 (previously reported as September 2009), the patient experienced vesicular lesions at right spinal root, started T4 T5 area. At the reporting time, it occurred at left buttock S4 S5 area. No further information is available.