Age: 62.0
Sex: F
Vaccine: VARZOS, VARZOS
Symptoms: External ear inflammation, Insomnia, Lip swelling, Oxygen saturation, Peak expiratory flow rate
Clinical narrative: Information has been received from a physician concerning a female who on 16-MAY-2008 was vaccinated subcutaneously with a first dose of ZOSTAVAX.  On 16-MAY-2008 the patient developed an urticaria/rash on their back and chest.  The physician also reported that the patient developed swelling of their lips.  The patient was treated with epinephrine and other medications (unspecified).  At the time of reporting the patient had not yet recovered, although it was noted that "when treated the swelling went down a little".  There was no product quality complaint.  Follow up information was received from the office manager inquiring about the VZVIP packet that the office had received.  The reporter noted that the patient had no vesicles or papules, just urticaria therefore a specimen would not be submitted.  The reporter noted that the patient had been vaccinated with ZOSTAVAX on 16-MAY-2008.  On 18-MAY-2008 the patient awoke at 6 am with widespread urticaria on her arms, back and chest, her ear was reddened, inflamed and swollen.  It was also noted that the patient developed shortness of breath and lip swelling (date unspecified).  It was noted that the patient took BENADRYL "all day".  "On Monday" (approximately 19 MAY 2008) the patient was seen in the office and was given epinephrine, XYZAL and treated with a medrol dose-pak.  It was reported that the patient was doing "better", but still had the rash.  The patient was instructed to call the office later in the week with her progress.  Follow-up information has been received from the physician's medical records dated 19-MAY-2008 (1:30 pm) concerning this 62 year old female patient with an allergy to amoxicillin (+) AUGMENTIN who on 16-MAY-2008 around 3:30 pm was vaccinated in the left deltoid with .5ml of ZOSTAVAX (lot # 659323/0164X).  Concomitant therapy included loratadine, gabapentin, meclizine hydrochloride, TEMOVATE, LESCOL XL, CITRACAL + D, ezetimibe, PLEGINE, NEXIUM, potassium (unspecified) and omega-3 marine triglycerides.  Medical records indicated that when the patient sought medical attention she appeared acutely ill and in mild-moderate distress.  The patient presented for possible allergic reaction to ZOSTAVAX starting early Sunday morning 18-MAY-2008 around 6 am.  The patient was awoken out of her sleep with left proximal palmar itching.  She thought she might have somehow been bitten by an insect.  However, the patient developed a whole body pruritic rash, swollen lips, mild shortness of breath and some difficulty swallowing.  The patient used BENADRYL and CLARITIN without much relief.  ADVAIR DISKUS was used and seemed to help some of the mild shortness of breath that she had experienced.  The patient did not know of any allergy to neomycin nor gelatin.  The patient had not eaten anything unusual nor had she had any recent illness or any other recent vaccinations or did any unusual traveling.  It was also noted that the patient was in a hot tub around 2 am Sunday morning.  At the time of the report the patient's status was not reported, but it was noted that the patient was currently under treatment.  Additional information has been requested.