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This is VAERS ID 478039

History of Changes from the VAERS Wayback Machine

First Appeared on 1/7/2013

VAERS ID: 478039
VAERS Form:
Age:68.0
Sex:Female
Location:Texas
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2012-12-14
Entered:2012-12-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER (ZOSTAVAX) / MERCK & CO. INC. - / - UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Condition aggravated, Death, Neuroendocrine carcinoma of the skin, Malignant neoplasm progression

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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:
Allergies:
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.


Changed on 6/14/2014

VAERS ID: 478039 Before After
VAERS Form:
Age:68.0
Sex:Female
Location:Texas
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2012-12-14
Entered:2012-12-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER (ZOSTAVAX) / MERCK & CO. INC. - / - UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Condition aggravated, Death, Neuroendocrine carcinoma of the skin, Malignant neoplasm progression

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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:
Allergies:
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.


Changed on 4/14/2017

VAERS ID: 478039 Before After
VAERS Form:
Age:68.0
Sex:Female
Location:Texas
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2012-12-14
Entered:2012-12-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER (ZOSTAVAX) / MERCK & CO. INC. - / - UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Condition aggravated, Death, Neuroendocrine carcinoma of the skin, Malignant neoplasm progression

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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:
Allergies:
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.


Changed on 9/14/2017

VAERS ID: 478039 Before After
VAERS Form:(blank) 1
Age:68.0
Sex:Female
Location:Texas
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2012-12-14
Entered:2012-12-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER (ZOSTAVAX) / MERCK & CO. INC. - / - UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Condition aggravated, Death, Neuroendocrine carcinoma of the skin, Malignant neoplasm progression

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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:
Allergies:
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.


Changed on 2/14/2018

VAERS ID: 478039 Before After
VAERS Form:1
Age:68.0
Sex:Female
Location:Texas
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2012-12-14
Entered:2012-12-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER (ZOSTAVAX) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Condition aggravated, Death, Neuroendocrine carcinoma of the skin, Malignant neoplasm progression

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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:
Allergies:
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.


Changed on 6/14/2018

VAERS ID: 478039 Before After
VAERS Form:1
Age:68.0
Sex:Female
Location:Texas
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2012-12-14
Entered:2012-12-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER (ZOSTAVAX) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Condition aggravated, Death, Neuroendocrine carcinoma of the skin, Malignant neoplasm progression

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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:
Allergies:
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.


Changed on 8/14/2018

VAERS ID: 478039 Before After
VAERS Form:1
Age:68.0
Sex:Female
Location:Texas
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2012-12-14
Entered:2012-12-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER (ZOSTAVAX) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Condition aggravated, Death, Neuroendocrine carcinoma of the skin, Malignant neoplasm progression

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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:
Allergies:
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.


Changed on 9/14/2018

VAERS ID: 478039 Before After
VAERS Form:1
Age:68.0
Sex:Female
Location:Texas
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2012-12-14
Entered:2012-12-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER (ZOSTAVAX) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Condition aggravated, Death, Neuroendocrine carcinoma of the skin, Malignant neoplasm progression

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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:
Allergies:
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.


Changed on 10/14/2018

VAERS ID: 478039 Before After
VAERS Form:1
Age:68.0
Sex:Female
Location:Texas
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2012-12-14
Entered:2012-12-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER (ZOSTAVAX) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Condition aggravated, Death, Neuroendocrine carcinoma of the skin, Malignant neoplasm progression

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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:
Allergies:
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.


Changed on 8/14/2019

VAERS ID: 478039 Before After
VAERS Form:1
Age:68.0
Sex:Female
Location:Texas
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2012-12-14
Entered:2012-12-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER (ZOSTAVAX) ZOSTER LIVE (ZOSTAVAX) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Condition aggravated, Death, Neuroendocrine carcinoma of the skin, Malignant neoplasm progression

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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:
Allergies:
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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