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The following is all the information available on report# VAERS_ID: 756388
Vaccine(s) were received on 06/23/2016
Vaccine(s) were received in the state: OK
Patient sex : F
Reaction was life threatening?: N
Patient eventually recovered from reaction ?: U
Patient eventually died?: N

The following Data for this patients ALLERGIES is available: [ ]

Description of adverse reaction: Information has been received from a lawyer regarding a case in litigation concerning a female patient of unknown age. No information has been received regarding the patient's past medical history, concurrent conditions, or concomitant medication. On 23-JUN-2016, the patient was inoculated with ZOSTAVAX vaccine (lot number, dosage and route of administration not provided), (by an unspecified healthcare professional) at a public health department as recommended for routine adult health maintenance and for the prevention of shingles. The vaccine did not prevent shingles, but rather caused the patient to contract a persistent strain of herpes zoster. Shortly after receiving ZOSTAVAX vaccine, the patient developed pain on her torso. On 05-OCT-2016, the patient presented to the physician, her primary care physician, and was diagnosed as suffering from polyneuropathy. Shortly thereafter, the patient returned to the physician and was diagnosed as suffering from internal shingles. As a direct and proximate result of


Vaccine(s) associated with report# 756388

TypeNameManufacturerVaccine LOT #Dose SeriesROUTESite
VARZOSZOSTER (ZOSTAVAX) MERCK & CO. INC.0

Symptoms(s) associated with report# 756388

Abdominal pain
Herpes zoster
Polyneuropathy