Age: 65.0
Sex: M
Vaccine: VARZOS
Symptoms: Pemphigoid, Pemphigus, Rash, Rash erythematous
Clinical narrative: shingles; This spontaneous report has been received from a lawyer, regarding a case in litigation and refers to a currently 74-year-old patient of unknown gender. The patient's concurrent conditions, medical history and concomitant medications were not reported. On or about 15-JAN-2013, the patient was administered zoster vaccine live (ZOSTAVAX) (dose, route of administration, anatomical location, lot # and expiry date were not provided) for the long-term prevention of shingles and zoster-related conditions, by a pharmacist at a pharmacy. Subsequently, on an unknown date, the patient was treated by a physician for the following injuries resulting from the patient's zoster vaccine live (ZOSTAVAX) use: shingles and other zoster related conditions. The outcome of the events was not reported. The reporter considered the events to be related to zoster vaccine live (ZOSTAVAX).  Follow-up information has been received on 24-FEB-2022 from a physician via a medical records, regarding case in litigation and refers to a 65-year-old male patient (pt). His concurrent conditions included actinic keratoses (treated with liquid nitrogen), skin growths on his chest and back (diagnosed as seborrheic keratoses) and growth on the right thigh, which itched intensely (diagnosed as inflamed seborrheic keratosis). His medical history included chickenpox. The pt's historical vaccines included unspecified trivalent (triv) influenza vaccines (on 31-AUG-2010 and 29-AUG-2012). On 15-JAN-2013, the pt was vaccinated with zoster vaccine live (ZOSTAVAX). On 21-JAN-2013, the pt presented at office visit with a chief complaint of rash. The rash was involving his left back. He stated that the rash had been present for one day (also reported as came on over a period of 24 hours, considered as on 20-JAN-2013). Before the rash occurred, he did not experience any burning pain in the area. He did not receive any previous treatment. It was reported that he received shingles vaccination on approximately 17-JAN-2013 (reported as approximately 4 days ago, conflicting information). Review of system (ROS) was positive for rash on his left back. Physical examination revealed vesicles on an erythematous base involving the left abdomen and left back. There was a dermatomal distribution. Exam of the rest of the body revealed no lesions this type. Differential diagnosis included: herpes zoster, pemphigus vulgaris, cellulitis and bullous pemphigoid of Brunsting-Perry. Impression included herpes zoster. The pt was given herpes zoster information sheet, which was reviewed with the physician. The pt was prescribed acyclovir 800 mg, orally (po) 5x a day for 10 days. The physician explained to the pt that pain and discomfort could last for 6 months or longer. He would to return to the clinic in 2 weeks. The pt's vaccinations included also unspecified trivalent (triv) influenza vaccines administered on 01-NOV-2013, 28-OCT-2014, 28-OCT-2015, 19-OCT-2016, unspecified influenza high dose vaccine administered on 08-OCT-2017, unspecified flu quadrivalent (quad) vaccine administered on 04-OCT-2018, unspecified influenza high dose vaccine administered on 06-DEC-2019, elasomeran (SPIKEVAX) (Moderna COVID-19 vaccine) administered on 17-JAN-2021, influenza virus split virion 4v vaccine inactivated (FLUZONE) administered on 26-AUG-2021 and elasomeran (SPIKEVAX) administered also on 25-FEB-2021 and 29-OCT-2021. The outcome of herpes zoster was not provided. The relatedness between the event and zoster vaccine live (ZOSTAVAX) was not reported.  All available medical records will be provided upon request.