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This is VAERS ID 420445

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History of Changes from the VAERS Wayback Machine

First Appeared on 4/13/2011

VAERS ID: 420445
VAERS Form:
Age:75.0
Sex:Male
Location:Unknown
Vaccinated:2010-04-01
Onset:2010-04-01
Submitted:2011-04-06
Entered:2011-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER (ZOSTAVAX) / MERCK & CO. INC. - / - UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Death, Herpes simplex, Herpes zoster, Simplex virus test positive

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-12-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Hydrocortisone
Current Illness: Leukopenia
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: herpes simplex virus, Confirmed it was the oka strain
CDC 'Split Type': WAES1103USA03961

Write-up: Information has been received from a physician concerning a 75 year old male with "chronic leukopenia" who in April 2010, was vaccinated with a dose of ZOSTAVAX (Merck) (lot # not reported). Concomitant therapy included hydrocortisone (manufacturer unknown). In May 2010, the patient developed shingles spread to his face. In October 2010, the patient was admitted to hospital with dissemination. Acyclovir IV was given for two weeks then Acyclovir oral for 2 weeks for the treatment of the adverse event. In December 2010, the patient was admitted again to the hospital and died three weeks later. On unspecified date, lab study was performed on the ZOSTAVAX (Merck) which confirmed it was the oka strain. Additional information has been requested.


Changed on 6/14/2014

VAERS ID: 420445 Before After
VAERS Form:
Age:75.0
Sex:Male
Location:Unknown
Vaccinated:2010-04-01
Onset:2010-04-01
Submitted:2011-04-06
Entered:2011-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER (ZOSTAVAX) / MERCK & CO. INC. - / - UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Death, Herpes simplex, Herpes zoster, Simplex virus test positive

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-12-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Hydrocortisone
Current Illness: Leukopenia
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: herpes simplex virus, Confirmed it was the oka strain
CDC 'Split Type': WAES1103USA03961

Write-up: Information has been received from a physician concerning a 75 year old male with "chronic leukopenia" who in April 2010, was vaccinated with a dose of ZOSTAVAX (Merck) (lot # not reported). Concomitant therapy included hydrocortisone (manufacturer unknown). In May 2010, the patient developed shingles spread to his face. In October 2010, the patient was admitted to hospital with dissemination. Acyclovir IV was given for two weeks then Acyclovir oral for 2 weeks for the treatment of the adverse event. In December 2010, the patient was admitted again to the hospital and died three weeks later. On unspecified date, lab study was performed on the ZOSTAVAX (Merck) which confirmed it was the oka strain. Additional information has been requested.


Changed on 6/14/2016

VAERS ID: 420445 Before After
VAERS Form:
Age:75.0
Sex:Male
Location:Unknown
Vaccinated:2010-04-01
Onset:2010-04-01
Submitted:2011-04-06
Entered:2011-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / - UN / UN
VARZOS: ZOSTER (ZOSTAVAX) / MERCK & CO. INC. - / - UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Death, Herpes simplex, Herpes zoster, Simplex virus test positive

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-12-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Hydrocortisone
Current Illness: Leukopenia
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: herpes simplex virus, Confirmed it was the oka strain
CDC 'Split Type': WAES1103USA03961

Write-up: Information has been received from a physician concerning a 75 year old male with "chronic leukopenia" who in April 2010, was vaccinated with a dose of ZOSTAVAX (Merck) (lot # not reported). Concomitant therapy included hydrocortisone (manufacturer unknown). In May 2010, the patient developed shingles spread to his face. In October 2010, the patient was admitted to hospital with dissemination. Acyclovir IV was given for two weeks then Acyclovir oral for 2 weeks for the treatment of the adverse event. In December 2010, the patient was admitted again to the hospital and died three weeks later. On unspecified date, lab study was performed on the ZOSTAVAX (Merck) which confirmed it was the oka strain. Additional information has been requested.


Changed on 9/14/2017

VAERS ID: 420445 Before After
VAERS Form:(blank) 1
Age:75.0
Sex:Male
Location:Unknown
Vaccinated:2010-04-01
Onset:2010-04-01
Submitted:2011-04-06
Entered:2011-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / - UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Death, Herpes simplex, Herpes zoster, Simplex virus test positive

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-12-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Hydrocortisone
Current Illness: Leukopenia
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: herpes simplex virus, Confirmed it was the oka strain
CDC 'Split Type': WAES1103USA03961

Write-up: Information has been received from a physician concerning a 75 year old male with "chronic leukopenia" who in April 2010, was vaccinated with a dose of ZOSTAVAX (Merck) (lot # not reported). Concomitant therapy included hydrocortisone (manufacturer unknown). In May 2010, the patient developed shingles spread to his face. In October 2010, the patient was admitted to hospital with dissemination. Acyclovir IV was given for two weeks then Acyclovir oral for 2 weeks for the treatment of the adverse event. In December 2010, the patient was admitted again to the hospital and died three weeks later. On unspecified date, lab study was performed on the ZOSTAVAX (Merck) which confirmed it was the oka strain. Additional information has been requested.


Changed on 2/14/2018

VAERS ID: 420445 Before After
VAERS Form:1
Age:75.0
Sex:Male
Location:Unknown
Vaccinated:2010-04-01
Onset:2010-04-01
Submitted:2011-04-06
Entered:2011-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Death, Herpes simplex, Herpes zoster, Simplex virus test positive

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-12-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Hydrocortisone
Current Illness: Leukopenia
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: herpes simplex virus, Confirmed it was the oka strain
CDC 'Split Type': WAES1103USA03961

Write-up: Information has been received from a physician concerning a 75 year old male with "chronic leukopenia" who in April 2010, was vaccinated with a dose of ZOSTAVAX (Merck) (lot # not reported). Concomitant therapy included hydrocortisone (manufacturer unknown). In May 2010, the patient developed shingles spread to his face. In October 2010, the patient was admitted to hospital with dissemination. Acyclovir IV was given for two weeks then Acyclovir oral for 2 weeks for the treatment of the adverse event. In December 2010, the patient was admitted again to the hospital and died three weeks later. On unspecified date, lab study was performed on the ZOSTAVAX (Merck) which confirmed it was the oka strain. Additional information has been requested.


Changed on 6/14/2018

VAERS ID: 420445 Before After
VAERS Form:1
Age:75.0
Sex:Male
Location:Unknown
Vaccinated:2010-04-01
Onset:2010-04-01
Submitted:2011-04-06
Entered:2011-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Death, Herpes simplex, Herpes zoster, Simplex virus test positive

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-12-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Hydrocortisone
Current Illness: Leukopenia
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: herpes simplex virus, Confirmed it was the oka strain
CDC 'Split Type': WAES1103USA03961

Write-up: Information has been received from a physician concerning a 75 year old male with "chronic leukopenia" who in April 2010, was vaccinated with a dose of ZOSTAVAX (Merck) (lot # not reported). Concomitant therapy included hydrocortisone (manufacturer unknown). In May 2010, the patient developed shingles spread to his face. In October 2010, the patient was admitted to hospital with dissemination. Acyclovir IV was given for two weeks then Acyclovir oral for 2 weeks for the treatment of the adverse event. In December 2010, the patient was admitted again to the hospital and died three weeks later. On unspecified date, lab study was performed on the ZOSTAVAX (Merck) which confirmed it was the oka strain. Additional information has been requested.


Changed on 8/14/2018

VAERS ID: 420445 Before After
VAERS Form:1
Age:75.0
Sex:Male
Location:Unknown
Vaccinated:2010-04-01
Onset:2010-04-01
Submitted:2011-04-06
Entered:2011-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Death, Herpes simplex, Herpes zoster, Simplex virus test positive

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-12-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Hydrocortisone
Current Illness: Leukopenia
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: herpes simplex virus, Confirmed it was the oka strain
CDC 'Split Type': WAES1103USA03961

Write-up: Information has been received from a physician concerning a 75 year old male with "chronic leukopenia" who in April 2010, was vaccinated with a dose of ZOSTAVAX (Merck) (lot # not reported). Concomitant therapy included hydrocortisone (manufacturer unknown). In May 2010, the patient developed shingles spread to his face. In October 2010, the patient was admitted to hospital with dissemination. Acyclovir IV was given for two weeks then Acyclovir oral for 2 weeks for the treatment of the adverse event. In December 2010, the patient was admitted again to the hospital and died three weeks later. On unspecified date, lab study was performed on the ZOSTAVAX (Merck) which confirmed it was the oka strain. Additional information has been requested.


Changed on 9/14/2018

VAERS ID: 420445 Before After
VAERS Form:1
Age:75.0
Sex:Male
Location:Unknown
Vaccinated:2010-04-01
Onset:2010-04-01
Submitted:2011-04-06
Entered:2011-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Death, Herpes simplex, Herpes zoster, Simplex virus test positive

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-12-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Hydrocortisone
Current Illness: Leukopenia
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: herpes simplex virus, Confirmed it was the oka strain
CDC 'Split Type': WAES1103USA03961

Write-up: Information has been received from a physician concerning a 75 year old male with "chronic leukopenia" who in April 2010, was vaccinated with a dose of ZOSTAVAX (Merck) (lot # not reported). Concomitant therapy included hydrocortisone (manufacturer unknown). In May 2010, the patient developed shingles spread to his face. In October 2010, the patient was admitted to hospital with dissemination. Acyclovir IV was given for two weeks then Acyclovir oral for 2 weeks for the treatment of the adverse event. In December 2010, the patient was admitted again to the hospital and died three weeks later. On unspecified date, lab study was performed on the ZOSTAVAX (Merck) which confirmed it was the oka strain. Additional information has been requested.


Changed on 10/14/2018

VAERS ID: 420445 Before After
VAERS Form:1
Age:75.0
Sex:Male
Location:Unknown
Vaccinated:2010-04-01
Onset:2010-04-01
Submitted:2011-04-06
Entered:2011-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Death, Herpes simplex, Herpes zoster, Simplex virus test positive

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-12-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Hydrocortisone
Current Illness: Leukopenia
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: herpes simplex virus, Confirmed it was the oka strain
CDC 'Split Type': WAES1103USA03961

Write-up: Information has been received from a physician concerning a 75 year old male with "chronic leukopenia" who in April 2010, was vaccinated with a dose of ZOSTAVAX (Merck) (lot # not reported). Concomitant therapy included hydrocortisone (manufacturer unknown). In May 2010, the patient developed shingles spread to his face. In October 2010, the patient was admitted to hospital with dissemination. Acyclovir IV was given for two weeks then Acyclovir oral for 2 weeks for the treatment of the adverse event. In December 2010, the patient was admitted again to the hospital and died three weeks later. On unspecified date, lab study was performed on the ZOSTAVAX (Merck) which confirmed it was the oka strain. Additional information has been requested.


Changed on 12/24/2020

VAERS ID: 420445 Before After
VAERS Form:1
Age:75.0
Sex:Male
Location:Unknown
Vaccinated:2010-04-01
Onset:2010-04-01
Submitted:2011-04-06
Entered:2011-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Death, Herpes simplex, Herpes zoster, Simplex virus test positive

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-12-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Hydrocortisone
Current Illness: Leukopenia
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: herpes simplex virus, Confirmed it was the oka strain
CDC 'Split Type': WAES1103USA03961

Write-up: Information has been received from a physician concerning a 75 year old male with "chronic leukopenia" who in April 2010, was vaccinated with a dose of ZOSTAVAX (Merck) (lot # not reported). Concomitant therapy included hydrocortisone (manufacturer unknown). In May 2010, the patient developed shingles spread to his face. In October 2010, the patient was admitted to hospital with dissemination. Acyclovir IV was given for two weeks then Acyclovir oral for 2 weeks for the treatment of the adverse event. In December 2010, the patient was admitted again to the hospital and died three weeks later. On unspecified date, lab study was performed on the ZOSTAVAX (Merck) which confirmed it was the oka strain. Additional information has been requested.


Changed on 12/30/2020

VAERS ID: 420445 Before After
VAERS Form:1
Age:75.0
Sex:Male
Location:Unknown
Vaccinated:2010-04-01
Onset:2010-04-01
Submitted:2011-04-06
Entered:2011-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Death, Herpes simplex, Herpes zoster, Simplex virus test positive

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-12-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Hydrocortisone
Current Illness: Leukopenia
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: herpes simplex virus, Confirmed it was the oka strain
CDC 'Split Type': WAES1103USA03961

Write-up: Information has been received from a physician concerning a 75 year old male with "chronic leukopenia" who in April 2010, was vaccinated with a dose of ZOSTAVAX (Merck) (lot # not reported). Concomitant therapy included hydrocortisone (manufacturer unknown). In May 2010, the patient developed shingles spread to his face. In October 2010, the patient was admitted to hospital with dissemination. Acyclovir IV was given for two weeks then Acyclovir oral for 2 weeks for the treatment of the adverse event. In December 2010, the patient was admitted again to the hospital and died three weeks later. On unspecified date, lab study was performed on the ZOSTAVAX (Merck) which confirmed it was the oka strain. Additional information has been requested.


Changed on 5/7/2021

VAERS ID: 420445 Before After
VAERS Form:1
Age:75.0
Sex:Male
Location:Unknown
Vaccinated:2010-04-01
Onset:2010-04-01
Submitted:2011-04-06
Entered:2011-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Death, Herpes simplex, Herpes zoster, Simplex virus test positive

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-12-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Hydrocortisone
Current Illness: Leukopenia
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: herpes simplex virus, Confirmed it was the oka strain
CDC 'Split Type': WAES1103USA03961

Write-up: Information has been received from a physician concerning a 75 year old male with "chronic leukopenia" who in April 2010, was vaccinated with a dose of ZOSTAVAX (Merck) (lot # not reported). Concomitant therapy included hydrocortisone (manufacturer unknown). In May 2010, the patient developed shingles spread to his face. In October 2010, the patient was admitted to hospital with dissemination. Acyclovir IV was given for two weeks then Acyclovir oral for 2 weeks for the treatment of the adverse event. In December 2010, the patient was admitted again to the hospital and died three weeks later. On unspecified date, lab study was performed on the ZOSTAVAX (Merck) which confirmed it was the oka strain. Additional information has been requested.


Changed on 5/14/2021

VAERS ID: 420445 Before After
VAERS Form:1
Age:75.0
Sex:Male
Location:Unknown
Vaccinated:2010-04-01
Onset:2010-04-01
Submitted:2011-04-06
Entered:2011-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Death, Herpes simplex, Herpes zoster, Simplex virus test positive

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-12-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Hydrocortisone
Current Illness: Leukopenia
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: herpes simplex virus, Confirmed it was the oka strain
CDC 'Split Type': WAES1103USA03961

Write-up: Information has been received from a physician concerning a 75 year old male with "chronic leukopenia" who in April 2010, was vaccinated with a dose of ZOSTAVAX (Merck) (lot # not reported). Concomitant therapy included hydrocortisone (manufacturer unknown). In May 2010, the patient developed shingles spread to his face. In October 2010, the patient was admitted to hospital with dissemination. Acyclovir IV was given for two weeks then Acyclovir oral for 2 weeks for the treatment of the adverse event. In December 2010, the patient was admitted again to the hospital and died three weeks later. On unspecified date, lab study was performed on the ZOSTAVAX (Merck) which confirmed it was the oka strain. Additional information has been requested.

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