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This is VAERS ID 478039

Case Details

VAERS ID: 478039 (history)  
Form: Version 1.0  
Age: 68.0  
Sex: Female  
Location: Texas  
Submitted: 2012-12-14
Entered: 2012-12-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Condition aggravated, Death, Malignant neoplasm progression, Neuroendocrine carcinoma of the skin
SMQs:, Malignancy related conditions (narrow), Skin malignant tumours (narrow), Non-haematological malignant tumours (narrow)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Neuroendocrine carcinoma of the skin; Systemic lupus erythematosus
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1212USA004903

Write-up: This spontaneous report as received from a licensed practical nurse refers to an approximately 68 years old female patient with lupus and merkel cell carcinoma. About 3 months ago (reported on 12-DEC-2012)(September 2012) the patient was vaccinated with a dose of 0.65 ml ZOSTAVAX (lot number and route were not reported) at an unspecified pharmacy in an unspecified location. No other co-suspects were reported. No concomitant medications were reported. The nurse reported that the patient was given the vaccine even though he had both lupus and merkel cell carcinoma. The nurse reported that after the vaccination, over the following 2 months, the cancer progressed more aggressively (death, medically significant, life threatening and hospitalization). On an unknown date the patient sought medical attention. The patient was admitted to the hospital (date not provided) and died while in the hospital. The patient died about a month ago. (November 2012) and the cause of death was reported as cancer. The patient''s doctor at the hospital told the patient''s family that he believed that the cancer''s progression was caused by ZOSTAVAX. Discrepant information reported in Source Document: patient is referred to as ''female'' in the patient section of the report, but referred to as ''he'' in Narrative. Additional information has been requested.

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