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#1 STD & Herpes Dating Site With 1+ Million Positive Singles

There are over 110 million people living with STDs in the US as well as an estimated 400 million people worldwide. So you are not alone! PositiveSingles is the best, largest, completely anonymous and most trusted online dating site for people with Herpes, HPV, HIV / AIDS and other STDs in the world. We have 60,000+ STD dating success stories, 120,000+ daily conversations, 15,000+ daily active members and 500+ daily blog posts.

When you have Herpes, HPV, HIV or any STDs, it can make you feel like you are all alone in the world. If you wish there was a herpes stuff place where you didn't have to worry about being rejected or discriminated against, PositiveSingles was designed with you in mind.

We care a great deal about your privacy. You are not required to submit any information that would make you uncomfortable. All your personal information can remain private and anonymous until you want to take things further. Everyone with an STD can join us regardless of race, religion, sexual orientation or gender. https://www.positivesingles.com/ At PositiveSingles, we have been helping people with STDs find love and support since 2001. This is a warm-hearted and exclusive community for singles with Herpes and STDs. Whether you are living with Herpes, HPV, HIV/AIDS or any other STDs, here you can meet new friends or even a potential spouse, find communal support and get on with your life. Meet Positive Singles in Jakarta TODAY and connect with more than one million singles like you now! (We have been in the online dating business for over 16 years!)

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Do You Need The Best STD Testing Centers?

If the Syphilis is on the second stage, the physician will check your lymph glands and for signs of rashes. A blood test will also be necessary to look for antibodies to the Syphilis bacteria. To test for Chlamydia infection in women, the physician will conduct a pelvic exam to look for signs of infection. The physician will also take a cervical swab which will be sent to a laboratory to examine it further. To test the Trichomoniasis, a pelvic exam is necessary to check for sores on your cervix. There will also be cervical swab combined with salt solution before the sample is examined under a microscope.

Most STD testing centers have routine tests for a few infections. So if there is a particular disease that you would like to be tested, ask your physician for it. STD tests are never accomplished by examining the pelvis or by having a routine physical exam alone. After the request for a particular STD test, your consent is needed before the test proceeds. It's easy to get STD tested at our Centers STD testing. Call and talk with a counselor to see if you need a test. If herpes stuff so, a doctor will prescribe the test. Give us a call at http://www.advancedtestingcenter.com and get same day appointment. Then discuss the results with our counselors. It's quick, easy, and confidential. Among the HIV symptoms are rapid weight loss, recurring fever, and unusual blemishes in the throat or mouth. To have a HIV AIDS test, a blood sample is needed. If the blood sample contains antibodies, you are positive for HIV. STD testing centers will also test for a very serious Human Immunodeficiency Virus. The HIV infection can be hard to detect at the initial stage because of absence of symptoms. Mostly, the HIV infection is detected at more advanced stages because of the symptoms that start to manifest. A typical STD urine test can determine several sexually transmitted diseases. Besides the urine test, the physicians may also examine your genitals by extracting fluid samples from the vagina, anus, urethra or throat. Blood or cell samples can determine viruses for Chlamydia, Gonorrhea, Syphilis, Trichomoniasis, Human Immunodeficiency Virus, HPV and Genital Herpes. STD testing centers are designed to determine the type of sexually transmitted disease you have acquired. Depending on the type of disease you would like to be tested for, there are HIV, Oral Herpes, HPV, Syphilis, Herpes and Gonorrhea testing. http://sample.ezinemark.com/do-you-need-the-best-std-testing-centers-3b8340b2068.html Every year, 700,000 people are infected or re-infected with Gonorrhea virus. To diagnose this STD, both a physical examination and culture test are needed. The physician or your healthcare provider will take a sample of any discharge from you. The sample will be sent to a laboratory for culture test that lasts for 2 days. After which, the sample is examined under a microscope. It is also possible to have urine test for Gonorrhea, but the results will not be as accurate as the culture test. The Chlamydia affected 2.8 million Americans in 2004. The Center for Disease Control and Prevention received reports of more than 900,000 Chlamydia infections. The symptoms of Chlamydia among women are mild or absent, making it difficult to notice. In 2002, more than 32,000 cases of Syphilis infection were reported in the United States. During the initial stages, the diagnosis can be done by having a physical examination and fluid samples from the chancres sores.

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Herpes in the Mouth

Oral herpes and genital herpes are very similar in appearance. However, they occur in different parts of the body. Oral herpes is an infection that causes painful blisters/sores in the mouth, inner cheeks, gums, roof of the mouth, tongue, and lips. This condition is sometimes accompanied by muscle pain and fever. Herpes symptoms commonly show in or around the mouth. Sores may also occur at the back of the throat, causing the lymph nodes in the neck to swell. Mouth herpes is very common in children, as their parents or relatives can pass it on to them easily by a greeting or goodnight kiss. To get a better understanding of oral herpes, let us take a look at its causes. ? Herpes in the mouth is generally caused by herpes simplex virus 1. ? It is highly contagious and spreads from person to person by the means of saliva, mucus or skin contact. ? Even touching or sharing something that is infected with the herpes virus like towels, used razors, lip balm, lipsticks, etc., can cause mouth herpes. ? It can be contracted easily through physical contact with any person who is infected. ? Oral herpes can be contracted by oral sex too. However, this is a rare happening, as genital herpes is caused by HSV-2. ? Other causes can include; excess sunlight on the lips, menstruation, change in hormones, emotional stress, mouth injury, fatigue, dental procedures, etc. ? Any which way, in some cases, the triggers of oral herpes are unknown. Precautions and Prevention ? Avoid salty and acidic food. ? Eat food that is cooling and soft to chew. ? Use a lip balm to prevent your lips from sticking to each other. ? Do not indulge in kissing or oral sex, until the sores are healed completely. ? Also, do not kiss anyone with oral or genital herpes. ? Use sunscreen on your lips to protect them from the sun. ? Do not share lipsticks, lip balms, creams, straws, cutlery or even a water glass with an infected person. ? Although very rare, herpes can be transmitted to a newborn too. Hence, if you are an expecting mother, consult your physician regarding oral herpes. Treatment Causes of Mouth Herpes During stage 1, the virus comes in contact with the skin, enters through cracks or breaks, and reproduces. In this phase, symptoms like fever might occur. The incubation period for oral herpes is between 2 to 12 days. The symptoms last for about 3 weeks. The symptoms may be mild or serious, and occur within the first three weeks after contracting the infection. These symptoms include; Herpes in the mouth is difficult to cure permanently. However, taking proper precautionary measures can definitely minimize the risk of its surfacing again and again. Stress and emotionally exerting circumstances can aggravate the condition of herpes. General Information These blisters may break open and leak a yellowish fluid. This fluid becomes crusty, as the blister heals and ultimately turns pink.

A physician can diagnose oral herpes by just looking at the infected area. A sample of the sore fluid may be sent for closer examination and confirmation herpes dating information of herpes, to the laboratory. Viral DNA test, Tzanck test or Viral culture test may be conducted for better diagnoses. ? Only human beings are affected by the herpes simplex virus. However, this is applicable to any human being, in any season of the year. ? In the United states of America, most people contract this infection before the age of 20. ? There are two types of viruses, namely; herpes simple virus 1 (HSV-1) and herpes simple virus 2 (HSV-2). Majority of oral herpes is caused by HSV-1. ? According to statistics, around two hundred and fifty four million Americans (more than 50 percent of the population) have contracted the infection of oral herpes through oral contact. ? Sometimes, after the first infection, the virus becomes dormant in the nerve tissues of the face. Later, the virus reactivates and causes cold sores. Diagnosis Disclaimer: The information provided in this article is solely for educating the reader. It is not intended to be a substitute for the advice of a medical expert. ? A burning or tingling sensation around the mouth area, ? Itchy lips or skin around the mouth, ? Pain while swallowing food, ? Swelling in glands and fever, ? Muscle pain and fatigue, ? Sore throat, ? Blisters or rash around the lips, gums, throat or mouth, ? Swollen or bleeding gums. The episode of oral herpes may clear up by itself within 7 days or more, and not even occur again. However, once the herpes virus is contracted, there is no way you can get it out of your system. A few measures can help with the pain caused by this infection. They are as follows; ? Drugs such as acetaminophen or ibuprofen, may be prescribed for fever and muscle ache. ? Over-the-counter cold sore creams or liquids may help in clearing these sores faster. ? Drinking plenty of water will prevent dehydration. ? If the blisters or sores get very painful, the doctor might prescribe a mouth wash for oral hygiene. ? However, there is always a risk that these symptoms might resurface, especially in stressful situations. http://www.buzzle.com/articles/herpes-inside-mouth.html Symptoms

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How – and why – tech has taken over our relationships

This is part of CNET's "It's Complicated" series about the role technology plays in our relationships. If you had to explain dating in 2017 to a time traveler from the 1950s, what would you say? "I would explain texting first, and how it takes five minutes now for people to decide they want to hook up," says comedian Nikki Glaser. "I would tell women, 'Buckle up, bitch, this is not going to be a fun ride.'" Glaser, 32, has made a professional study of dating sites like Tinder and the hookup culture that experts say has reshaped many people's sex lives. It provides lots of fodder for her comedy routine. For past generations, relationship milestones meant things like "going steady." Today's relationships can strike up after a few minutes of text chats. And since nearly everything is done using an app on a phone, "you can have a relationship with someone and never hear their voice," Glaser says. So this is dating in the modern age. Having fun yet? Dating apps are so ubiquitous now that swipe right, the way you show you like someone on Tinder, has become part of our everyday language. "Swipe right" now means "anytime you make a good choice or approve of something," according to Urban Dictionary. The internet has been "transformational" to the way we have relationships, says Pepper Schwartz, a professor of sociology at the University of Washington who studies dating. She's noticed, for example, the speed at which technological trends ripple through our culture, and how quickly people become adopters. "It changes us," she said. "It's a very powerful presence in modern life." That's particularly true in courtship and dating, Schwartz said. Go back a couple hundred years, and the world was transitioning from arranged marriages to "love." (Schwartz said researchers could tell because children weren't getting married in order of oldest to youngest anymore.) Up until the automobile, airplane and mass education, people usually married someone nearby, such as a neighbor, a fellow churchgoer or the girl next door. But these shifts fractured many communities. That, along with sex education, family planning and, in some places, egg freezing as a company-provided health benefit, has meant many people are waiting longer before they settle down. Who hasn't read about how millennials are less religious, have fewer kids and, despite the popularity of Tinder and the less formal dating culture it's helped introduce, may even be having less sex. The term "cybersex," which used to mean people describing sexual experiences to each other over chat, has morphed into "sexting" -- and it's a far more accepted part of life. Varying sexuality and gender identity are more accepted today as well. So as time passes and people move around, the traditional pools from which you'd normally find a partner pretty much disappear, Schwartz said. That leaves today's relationship seeker with few options other than to look online. It's no wonder then that over 90 percent of America's more than 54 million singles have tried online dating, according to the Statistic Brain Research Institute. Over the past decade, dating services have been set up Behance.net for pretty much any interest. If you wanted to date only people who like Star Trek, normally you'd have to weed through several p'tahks before finding someone to join your crew, as it were. Now there's a site for pretty Stark Trek fans, as well as sites for vampire enthusiasts, gamers and even devotees to the writings of Ayn Rand. There's even a site for supporters of the newly inaugurated president of the United States. It's called TrumpSingles.com. Rapid change Tinder's simple but addicting formula of swiping right on a profile you like, and then getting an alert if that person swipes right on you, has become such a cultural sensation that Glaser began doing skits about it. Watching how friends and coworkers used the app, she developed a theory that a not-small number of men would be willing to say pretty much anything in a text message conversation if they believed they might hook up. So she tested it in a segment called Tinder Tapout for her late night Comedy Central show, "Not Safe with Nikki Glaser," which ran for 20 episodes last year. She and her team created fake profiles of good-looking women, then struck up conversations with real-life men. The joke: See how long the men stick with the conversation as the fake women say increasingly crazy things. Glaser started one conversation by having a fictional female celebrate that she'd just sold a stolen wheelchair. In another, she told a marine she had PTSD, "Party Till Severely Dumber." He responded, "What's your favorite color?" "People went further than you would ever think," Glaser said. Her theory is that the men had so many conversations going that her character was "another fish in the sea to them." Tinder isn't unique, it's just one of the most well-known. Other apps, such as Grindr, used by the gay community, and Bumble, in which women make the first move, have joined staples like OkCupid, Match.com and eHarmony as go-to dating services on the web. Not everyone likes the seeming minefield of internet dating, though. That's when they turn to Amber Kelleher-Andrews and her matchmaking service, Kelleher International, founded by her mother Jill Kelleher in 1986 just outside San Francisco. With prices ranging from $25,000 to $300,000, her clientele skews toward the rich and famous. But she said many people come to her after having given up on the app world. "There are people who it isn't working for," she said. "The people who come to matchmakers are highly frustrated." Kelleher, who met her husband in school despite her mother's attempts to match her with other men, is considering bringing a lower-priced version of her service onto the internet too. One idea she's considering is taking over the management of a person's online profile, and then helping select dates among the swipes and winks that pile up. "People are really bad at choosing by themselves," she said. The new normal It's easy to forget modern smartphones came on the scene only a decade ago, when Steve Jobs unveiled the first iPhone. The mobile app boom came afterward, helping make services like Uber, Twitter, Instagram and Tinder household names. We're still feeling the effects that technological change is having on our culture and how we communicate, said Nicole Ellison, a professor at the University of Michigan School of Information. For example, people routinely strike up a conversation about something someone said online, like if a colleague posted about his child's birthday on Facebook. A few years ago, that might have been considered creepy. Now it's pleasant and thoughtful. We may reach a point where tech helps us more easily find people in our daily lives, Ellison said, and not just find someone to meet up with later. Imagine, for example, an app that points out a fellow Game of Thrones fan at a party, so you can more easily strike up a conversation. "We have more information about people than ever before, and many of us have these supercomputers in our pocket that have geolocation capabilities to see who's around us in space," she said. Together, that information could help us more easily talk to each other and find common ground. "That would be my hope," she said. In the meantime, people like Glaser are asking for less ambitious technologies to fix some of the inconveniences of today's dating scene. At the top of her list is an undo button for text messages, like how Google's Gmail gives you 30 seconds to cancel an email after you https://www.dating.dk/ press Send. "We've all sent off things we regret," she said. "It's crazy that that can make or break a relationship." Then again, maybe not. Time travelers beware. CNET Magazine: Check out a sampling of the stories you'll find in CNET's newsstand edition. Batteries Not Included: The CNET team shares experiences that remind us why tech stuff is cool. This article originally appeared on CNET.com as "Here's why tech has taken over our relationships." http://www.cbsnews.com/news/tech-has-taken-over-our-relationships-dating-sites-tinder/

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ADDING and REPLACING FDA Expands Indication for ZOSTAVAX®, Merck’s Shingles Vaccine, to Include Adults Ages 50 to 59

Injection-site adverse reactions reported at an incidence >=1% are shown in Table3. Most of these adverse reactions were reported as mild in intensity. The overall incidence of vaccine-related injection-site adverse reactions was significantly greater for subjects vaccinated with ZOSTAVAX versus subjects who received placebo (48% for ZOSTAVAX and 17% for placebo). About ZOSTAVAX (Zoster Vaccine Live) (N = 19,270) Most Common Adverse Reactions and Experiences in the AE Monitoring Substudy of the SPS ZOSTAVAX What should I tell my health care provider before I get ZOSTAVAX? Shingles is marked by a blistering rash and is caused by the reactivation of VZV, the same virus that causes chickenpox. After someone has had chickenpox, the virus never leaves their body, remaining inactive in certain nerve roots in the body for many years. If the virus becomes active again -- usually later in life -- it causes shingles. 8.4 Pediatric Use redness, pain, itching, swelling, hard lump, warmth, or bruising where the shot was given. headache The median age of subjects enrolled in the largest (N=38,546) clinical study of ZOSTAVAX was 69years (range 59-99years). Of the 19,270subjects who received ZOSTAVAX, 10,378 were 60-69years of age, 7,629 were 70-79years of age, and 1,263 were 80years of age or older. Placebo 50-59 15 REFERENCES Vaccination with ZOSTAVAX does not result in protection of all vaccine recipients. # subjects # HZ cases Incidence rate of HZ per 1000 person-yrs. ZOSTAVAX may be stored and/or transported at refrigerator temperature between 36F and 46F (2C to 8C) for up to 72continuous hours prior to reconstitution. Vaccine stored between 36F and 46F (2C to 8C) that is not used within 72 hours of removal from +5F (-15C) storage should be discarded. ZOSTAVAX should be reconstituted immediately upon removal from the freezer. The diluent should be stored separately at room temperature (68F to 77F, 20C to 25C), or in the refrigerator (36F to 46F, 2C to 8C). (N = 3345) 9989113 Serious complications, such as PHN, scarring, bacterial superinfection, allodynia, cranial and motor neuron palsies, pneumonia, encephalitis, visual impairment, hearing loss, and death can occur as the result of zoster. # subjects # HZ cases # PHN cases Incidence rate of PHN per 1,000 person-yrs. Headache was the only systemic adverse reaction reported on the vaccine report card between Days 0-42 by >=1% of subjects in the AE Monitoring Substudy in either vaccination group (ZOSTAVAX 1.4%, placebo 0.8%). Placebo If you do get shingles even though you have been vaccinated, ZOSTAVAX may help prevent the nerve pain that can follow shingles in some people. ZOSTAVAX does not protect everyone, so some people who get the vaccine may still get shingles. (N = 19,276) 69.8% (54.1%, 80.6%) 14 CLINICAL STUDIES Merck (NYSE: MRK), known as MSD outside the United States and Canada, announced today that the U.S. Food and Drug Administration (FDA) has approved an expanded age indication for ZOSTAVAX (Zoster Vaccine Live) for the prevention of herpes zoster, commonly known as shingles, in adults 50 years of age and older. In a large clinical study, ZOSTAVAX significantly reduced the risk of developing shingles by nearly 70 percent in adults ages 50 to 59, compared with placebo. ZOSTAVAX is the only shingles vaccine licensed for use in the U.S. Based on historical coverage information, Merck estimates that over 90 percent of people 60 and older in the U.S. who have private health insurance are in plans that have approved reimbursement of ZOSTAVAX, and Medicare Part D plans covering over 90 percent of Part D enrollees in the U.S. have included ZOSTAVAX on formulary. Whether a patient has coverage, and the amount of reimbursement, depends on the patient's benefit design, including any applicable co-pays, coverage limitations, co-insurance and/or deductibles and the reimbursement rate adopted by each plan. ZOSTAVAX is also a covered medical benefit for people 60 and older under the U.S. Veterans Health Administration and TRICARE, the health plan for the U.S. Department of Defense Military Health System. Suspension for subcutaneous injection ZOSTAVAX is a live attenuated virus vaccine indicated for prevention of herpes zoster (shingles) in individuals 50 years of age and older. Serious adverse reactions, including anaphylaxis, have occurred with ZOSTAVAX. Adequate treatment provisions, including epinephrine injection (1:1,000), should be available for immediate use should an anaphylactic/anaphylactoid reaction occur. 6.596 FULL PRESCRIBING INFORMATION: CONTENTS* "Merck is investing more than $1 billion to enhance manufacturing so that as many people as possible may have access to ZOSTAVAX and our other varicella-containing vaccines," said Julie L. Gerberding, M.D., president, Merck Vaccines. "Merck remains committed to this important vaccine and to our customers who continue to support ZOSTAVAX and the critical role of adult vaccination in public health." 6.2 VZV Rashes Following Vaccination RECENT MAJOR CHANGES According to the U.S. Centers for Disease Control and Prevention (CDC), in the U.S. approximately 1 in 3 people will experience shingles in their lifetime and nearly one million cases of shingles occur each year. The incidence and severity of shingles increase with age. Once a person has had chickenpox the varicella-zoster virus (VZV) stays inside the body and can resurface later as shingles. Efficacy of ZOSTAVAX was evaluated in the Shingles Prevention Study (SPS),a placebo-controlled, double-blind clinical trial in which 38,546subjects 60years of age or older were randomized to receive a single dose of either ZOSTAVAX (n=19,270) or placebo (n=19,276). Subjects were followed for the development of zoster for a median of 3.1 years (range 31days to 4.90years). The study excluded people who were immunocompromised or using corticosteroids on a regular basis, anyone with a previous history of HZ, and those with conditions that might interfere with study evaluations, including people with cognitive impairment, severe hearing loss, those who were non-ambulatory, and those whose survival was not considered to be at least 5 years. Randomization was stratified by age, 60-69 and >=70years of age. Suspected zoster cases were confirmed by Polymerase Chain Reaction (PCR) [93%], viral culture [1%], or in the absence of virus detection, as determined by a Clinical Evaluation Committee [6%]. Individuals in both vaccination groups who developed zoster were given famciclovir, and, as necessary, pain medications. The primary efficacy analysis included all subjects randomized in the study who were followed for at least 30 days postvaccination and did not develop an evaluable case of HZ within the first 30 days postvaccination (Modified Intent-To-Treat [MITT] analysis). 2 DOSAGE AND ADMINISTRATION Complication Placebo For people who don't have insurance and meet other eligibility criteria, Merck makes ZOSTAVAX, and other Merck vaccines indicated for use in appropriate people ages 19 and older, available free of charge through the Merck Vaccine Patient Assistance Program. More information on the Merck Vaccine Patient Assistance Program can be found at www.merckhelps.com or by calling 1-800-293-3881. 4.2 Immunosuppression Musculoskeletal and connective tissue disorders: arthralgia; myalgia 1.994 ZOSTAVAX contains a weakened chickenpox virus (varicella-zoster virus). 12.1 Mechanism of Action [See FDA-Approved Patient Labeling.] (N = 11116) Placebo Serious vaccine-related adverse reactions that have occurred following vaccination with ZOSTAVAX include asthma exacerbation and polymyalgia rheumatica. Other serious adverse events reported following vaccination with ZOSTAVAX include cardiovascular events (congestive heart failure, pulmonary edema). The rate of serious adverse reactions from Days 0 to 42 postvaccination may be increased. Common adverse reactions occurring in >=1% of vaccinated individuals during clinical trials include injection-site reactions (erythema, pain/tenderness, swelling, hematoma, pruritus, warmth) and headache. ZOSTAVAX is a live attenuated virus vaccine indicated for prevention of herpes zoster (shingles) in individuals 50 years of age and older. ZOSTAVAX is not indicated for the treatment of zoster or postherpetic neuralgia (PHN). ZOSTAVAX should not be used for prevention of primary varicella infection (Chickenpox). Shingles is caused by the same virus that causes chickenpox. Once you have had chickenpox, the virus can stay in your nervous system for many years. For reasons that are not fully understood, the virus may become active again and give you shingles. Age and problems with the immune system may increase your chances of getting shingles. The Adverse Event Monitoring Substudy of the SPS, designed to provide detailed data on the safety profile of the zoster vaccine (n=3,345 received ZOSTAVAX and n=3,271 received placebo) used vaccination report cards (VRC) to record adverse events occurring from Days 0 to 42 postvaccination (97% of subjects completed VRC in both vaccination groups). In addition, monthly surveillance for hospitalization was conducted through the end of the study, 2 to 5 years postvaccination. 8.5 Geriatric Use 8.1 Pregnancy In clinical trials in support of the initial licensure of the frozen formulation of ZOSTAVAX, the reported rates of noninjection-site zoster-like and varicella-like rashes within 42days postvaccination were also low in both zoster vaccine and placebo recipients. Of 17reported varicella-like rashes and noninjection-site, zoster-like rashes, 10specimens were available and adequate for PCR testing. The Oka/Merck strain was identified by PCR analysis from the lesion specimens of two subjects who reported varicella-like rashes (onset on Day 8 and 17). ZOSTAVAX (Zoster Vaccine Live) significantly reduced the incidence of shingles by nearly 70 percent in adults ages 50 to 59 13 NONCLINICAL TOXICOLOGY 6.3 Postmarketing Experience 6.1 Clinical Trials Experience What are the ingredients of ZOSTAVAX? DOSAGE FORMS AND STRENGTHS The incidence of death was similar in the groups receiving ZOSTAVAX or placebo during the Days 0-42 postvaccination period; 14 deaths occurred in the group of subjects who received ZOSTAVAX and 16 deaths occurred in the group of subjects who received placebo. The most common reported cause of death was cardiovascular disease (10 in the group of subjects who received ZOSTAVAX, 8 in the group of subjects who received placebo). The overall incidence of death occurring at any time during the study was similar between vaccination groups: 793 deaths (4.1%) occurred in subjects who received ZOSTAVAX and 795 deaths (4.1%) in subjects who received placebo. The following additional side effects have been reported in general use with ZOSTAVAX: Adverse Reaction Zoster Vaccine Live 9989113 To report SUSPECTED ADVERSE REACTIONS, contact Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., at 1-877-888-4231 or VAERS at 1-800-822-7967 or www.vaers.hhs.gov. Zoster Vaccine Live Shingles is a rash that is usually herpes dating information on one side of the body. The rash begins as a cluster of small red spots that often blister. The rash can be painful. Shingles rashes usually last up to 30 days and, for most people, the pain associated with the rash lessens as it heals. ZOSTAVAX significantly reduced the risk of developing zoster when compared with placebo (Table 5). In the SPS, vaccine efficacy for the prevention of HZ was highest for those subjects 60-69 years of age and declined with increasing age. Patient Information about 4.3 Pregnancy

1. Reitschel RL, Bernier R. Neomycin sensitivity and the MMR vaccine. JAMA 1981;245(6):571. # subjects # HZ cases Incidence rate of HZ per 1000 person-yrs. In the overall SPS study population, serious adverse events occurred at a similar rate (1.4%) in subjects vaccinated with ZOSTAVAX or placebo. In the SPS, the largest clinical trial of ZOSTAVAX, subjects received a single dose of either ZOSTAVAX (n=19,270) or placebo (n=19,276). The racial distribution across both vaccination groups was similar: White (95%); Black (2.0%); Hispanic (1.0%) and Other (1.0%) in both vaccination groups. The gender distribution was 59% male and 41% female in both vaccination groups. The age distribution of subjects enrolled, 59-99 years, was similar in both vaccination groups. The most frequent adverse reactions, reported in >=1% of subjects vaccinated with ZOSTAVAX, were headache and injection-site reactions. 2 DOSAGE AND ADMINISTRATION 5 WARNINGS AND PRECAUTIONS ZOSTAVAX 16 HOW SUPPLIED/STORAGE AND HANDLING Supply of ZOSTAVAX (Zoster Vaccine Live) Placebo 8.4 Pediatric Use Printed in USA % HZ cases with PHN Within the 42-day postvaccination reporting period in the SPS, noninjection-site zoster-like rashes were reported by 53 subjects (17 for ZOSTAVAX and 36 for placebo). Of 41 specimens that were adequate for Polymerase Chain Reaction (PCR) testing, wild-type VZV was detected in 25 (5 for ZOSTAVAX, 20 for placebo) of these specimens. The Oka/Merck strain of VZV was not detected from any of these specimens. Of reported varicella-like rashes (n=59), 10 had specimens that were available and adequate for PCR testing. VZV was not detected in any of these specimens. 7.2 Antiviral Medications Herpes zoster (HZ), commonly known as shingles or zoster, is a manifestation of the reactivation of varicella zoster virus (VZV), which, as a primary infection, produces chickenpox (varicella). Following initial infection, the virus remains latent in the dorsal root or cranial sensory ganglia until it reactivates, producing zoster. Zoster is characterized by a unilateral, painful, vesicular cutaneous eruption with a dermatomal distribution. Age group (yrs.)+ ADVERSE REACTIONS ZOSTAVAX is a lyophilized preparation of live, attenuated varicella-zoster virus (Oka/Merck) to be reconstituted with sterile diluent to give a single dose suspension with a minimum of 19,400 PFU (plaque forming units) when stored at room temperature for up to 30 minutes. Question the patient about reactions to previous vaccines. Provide a copy of the patient information (PPI) located at the end of this insert and discuss any questions or concerns. Inform patient of the benefits and risks of ZOSTAVAX, including the potential risk of transmitting the vaccine virus to susceptible individuals, such as immunosuppressed or immunodeficient individuals or pregnant women who have not had chickenpox. Instruct patient to report any adverse reactions or any symptoms of concern to their healthcare professional. Dist. by: Merck Sharp & Dohme Corp., a subsidiary of Merck Vaccine Patient Assistance Program WHITEHOUSE STATION, N.J.--(BUSINESS WIRE)--Re-issuing release dated March 24, 2011 with updated prescribing information. 4.2 Immunosuppression In two large clinical trials (ZEST and SPS), ZOSTAVAX significantly reduced the risk of developing zoster when compared with placebo (see Table 4 and Table 5). 8.3 Nursing Mothers Copyright 2006 Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc. 99 The most common side effects that people in the clinical studies reported after receiving the vaccine include: Inactive Ingredients: sucrose, hydrolyzed porcine gelatin, sodium chloride, monosodium L-glutamate, sodium phosphate dibasic, potassium phosphate monobasic, potassium chloride. 8 USE IN SPECIFIC POPULATIONS Within the 42-day postvaccination reporting period in the ZEST, noninjection-site zoster-like rashes were reported by 34 subjects (19 for ZOSTAVAX and 15 for placebo). Of 24 specimens that were adequate for Polymerase Chain Reaction (PCR) testing, wild-type VZV was detected in 10 (3 for ZOSTAVAX, 7 for placebo) of these specimens. The Oka/Merck strain of VZV was not detected from any of these specimens. Of reported varicella-like rashes (n=124, 69 for ZOSTAVAX and 55 for placebo), 23 had specimens that were available and adequate for PCR testing. VZV was detected in one of these specimens in the ZOSTAVAX group; however, the virus strain (wild-type or Oka/Merck strain) could not be determined. Overall 39%(++) Consumers and healthcare providers can visit www.zostavax.com to search an online database called the "Directory to Find ZOSTAVAX" to obtain a list of physician offices or pharmacies within their selected area that make ZOSTAVAX available and that may have supply in stock. People using this directory are encouraged to contact the locations directly to determine whether they currently have product available. In a double-blind, controlled substudy, 374 adults in the US, 60 years of age and older (median age = 66 years), were randomized to receive trivalent inactivated influenza vaccine (TIV) and ZOSTAVAX concurrently (N=188), or TIV alone followed 4 weeks later by ZOSTAVAX alone (N=186). The antibody responses to both vaccines at 4 weeks postvaccination were similar in both groups. 4.3 Pregnancy 8.5 Geriatric Use HIGHLIGHTS OF PRESCRIBING INFORMATION In the ZEST study, serious adverse events occurred at a similar rate in subjects vaccinated with ZOSTAVAX (0.6%) or placebo (0.5%) from Days 1 to 42 postvaccination. Transmission of vaccine virus may occur between vaccinees and susceptible contacts. Deferral should be considered in acute illness (for example, in the presence of fever) or in patients with active untreated tuberculosis. Table 5 Efficacy of ZOSTAVAX on HZ Incidence Compared with Placebo in the Shingles Prevention Study* ZOSTAVAX In this study, 30 cases of shingles occurred in the vaccine group versus 99 cases of shingles in the placebo group: efficacy of the vaccine was 69.8 percent (95 percent Confidence Interval [CI]: 54.1 percent, 80.6 percent), which met the study's pre-specified criterion for success. Varicella-zoster virus antibody levels (Geometric Mean Titers, GMT), as measured by glycoprotein enzyme-linked immunosorbent assay (gpELISA) six weeks after vaccination, were increased 2.3-fold (95 percent CI: 2.2 percent, 2.4 percent) in the group of subjects who received ZOSTAVAX compared to subjects who received placebo, meeting the pre-specified success criterion for this endpoint. Cohort 11 DESCRIPTION In a randomized clinical study, a reduced immune response to ZOSTAVAX as measured by gpELISA was observed in individuals who received concurrent administration of PNEUMOVAX 23 and ZOSTAVAX compared with individuals who received these vaccines 4 weeks apart. Consider administration of the two vaccines separated by at least 4 weeks [see Clinical Studies (14.3)]. The first signs of shingles are often felt and may not be seen, and can include itching, tingling, or burning. Later, a painful rash of fluid-filled blisters appears, usually on one side of the body or face. The rash may take two to four weeks to heal, and the pain from the rash can range from mild to severe. ZOSTAVAX 8 USE IN SPECIFIC POPULATIONS n/N % Table 1 Injection-Site Adverse Reactions Reported in >=1% of Adults Who Received ZOSTAVAX or Placebo Within 5 Days Post-Vaccination in the ZOSTAVAX Efficacy and Safety Trial WARNINGS AND PRECAUTIONS For further product information call 1-800-MERCK-90. Rx Only 11 DESCRIPTION You should read this summary of information about ZOSTAVAX before you are vaccinated. If you have any questions about ZOSTAVAX after reading this leaflet, you should ask your health care provider. This information does not take the place of talking about ZOSTAVAX with your doctor, nurse, or other health care provider. Only your health care provider can decide if ZOSTAVAX is right for you. Generic name: Zoster Vaccine Live What is ZOSTAVAX and how does it work? To maintain potency, ZOSTAVAX must be stored frozen between -58F and +5F (-50C and -15C). Use of dry ice may subject ZOSTAVAX to temperatures colder than -58F (-50C). Tell your healthcare provider if you have any new or unusual symptoms after you receive ZOSTAVAX. For a complete list of side effects, ask your health care provider. Storage Compared with placebo, ZOSTAVAX significantly reduced the risk of developing zoster by 69.8% (95% CI [54.1, 80.6%]) in subjects 50 to 59 years of age (Table 4). Specific complications* of zoster among HZ cases in the Shingles Prevention Study 14.3 Concomitant Use Studies ZOSTAVAX ZOSTAVAX is not indicated for the treatment of zoster or postherpetic neuralgia (PHN) (1) ZOSTAVAX is not indicated for prevention of primary varicella infection (Chickenpox) (1) The overall incidence of vaccine-related injection-site adverse reactions within 5 days post-vaccination was greater for subjects vaccinated with ZOSTAVAX as compared to subjects who received placebo (63.6% for ZOSTAVAX and 14.0% for placebo). Injection-site adverse reactions occurring at an incidence >=1% within 5 days post-vaccination are shown in Table 1. 13 NONCLINICAL TOXICOLOGY 2.1 Recommended Dose and Schedule Skin and subcutaneous tissue disorders: rash You should not get ZOSTAVAX to prevent chickenpox. Limitations of Use of ZOSTAVAX: 2.2 Preparation for Administration Pregnancy Category: Contraindication [see Contraindications (4.3)]. Because clinical trials are conducted under widely varying conditions, rates of adverse reactions observed in the clinical trials of a vaccine cannot be directly compared to rates in the clinical trials of another vaccine and may not reflect the rates observed in practice. Immune system disorders: hypersensitivity reactions including anaphylactic reactions 17 PATIENT COUNSELING INFORMATION No. 4963-41 -- ZOSTAVAX is supplied as follows: (1)a package of 10single-dose vials of lyophilized vaccine, NDC 0006-4963-41 (packageA); and (2)a separate package of 10vials of diluent (packageB). Most Common Adverse Reactions and Experiences in the ZEST Study 6 ADVERSE REACTIONS Deaths 2.2 Preparation for Administration Limitations of Use of ZOSTAVAX: In a randomized clinical study, a reduced immune response to ZOSTAVAX as measured by gpELISA was observed in individuals who received concurrent administration of PNEUMOVAX 23 and ZOSTAVAX compared with individuals who received these vaccines 4 weeks apart. Consider administration of the two vaccines separated by at least 4 weeks (7.1, 14.3). ZOSTAVAX 3. Coplan PM, Schmader K, Nikas A, Chan ISF, Choo P, Levin MJ, et al. Development of a measure of the burden of pain due to herpes zoster and postherpetic neuralgia for prevention trials: Adaptation of the brief pain inventory. J Pain 2004;5(6):344-56. (N = 11094) 3 DOSAGE FORMS AND STRENGTHS 7 DRUG INTERACTIONS Before reconstitution, protect from light. Select safety information Shingles Prevention Study (SPS) in Subjects 60 Years of Age and Older +The analysis was performed on the intent-to-treat (ITT) population that included all subjects randomized in the ZEST study. Vaccination with ZOSTAVAX may not result in protection of all vaccine recipients. 13.1 Carcinogenesis, Mutagenesis, Impairment of Fertility Use only the diluent supplied. Withdraw the entire contents of the diluent into a syringe. To avoid excessive foaming, slowly inject all of the diluent in the syringe into the vial of lyophilized vaccine and gently agitate to mix thoroughly. Withdraw the entire contents of reconstituted vaccine into a syringe and inject the total volume subcutaneously. ADMINISTER IMMEDIATELY AFTER RECONSTITUTION to minimize loss of potency. Discard reconstituted vaccine if not used within 30 minutes. Do not freeze reconstituted vaccine. 8.1 Pregnancy 14.2 Shingles Prevention Study (SPS) in Subjects 60 Years of Age and Older This leaflet summarizes important information about ZOSTAVAX. If you would like more information, talk to your health care provider or visit the website at www.ZOSTAVAX.com or call 1-800-622-4477. Table 2 Number of Subjects with >=1 Serious Adverse Events (0-42 Days Postvaccination) in the Shingles Prevention Study ZOSTAVAX is stored frozen and should be reconstituted immediately upon removal from the freezer. 14 CLINICAL STUDIES ZOSTAVAX ZOSTAVAX 7.2 Antiviral Medications ------------------------- USE IN SPECIFIC POPULATIONS -------------------- Forty-five subjects were excluded from the MITT analysis (16 in the group of subjects who received ZOSTAVAX and 29 in the group of subjects who received placebo), including 24 subjects with evaluable HZ cases that occurred in the first 30 days postvaccination (6 evaluable HZ cases in the group of subjects who received ZOSTAVAX and 18 evaluable HZ cases in the group of subjects who received placebo). Table 6 Postherpetic Neuralgia (PHN)* in the Shingles Prevention Study** % ZOSTAVAX has not been evaluated for its carcinogenic or mutagenic potential, or its potential to impair fertility. Injection-Site Deferral should be considered in acute illness (for example, in the presence of fever) or in patients with active untreated tuberculosis. DRUG INTERACTIONS Subcutaneous administration only. Do not inject intravascularly or intramuscularly. ZOSTAVAX is a vaccine that is used for adults 50 years of age or older to prevent shingles (also known as zoster). 14.1 ZOSTAVAX Efficacy and Safety Trial (ZEST) in Subjects 50 to 59 Years of Age In the ZEST study, subjects received a single dose of either ZOSTAVAX (N=11,184) or placebo (N=11,212). The racial distribution across both vaccination groups was similar: White (94.4%); Black (4.2%); Hispanic (3.3) and Other (1.4%) in both vaccination groups. The gender distribution was 38% male and 62% female in both vaccination groups. The age distribution of subjects enrolled, 50 to 59 years, was similar in both vaccination groups. All subjects received a vaccination report card (VRC) to record adverse events occurring from Days 1 to 42 postvaccination. The remainder of subjects in the SPS (n=15,925 received ZOSTAVAX and n=16,005 received placebo) were actively followed for safety outcomes through Day 42 postvaccination and passively followed for safety after Day 42. Copyright 2006 Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc. Customers can order ZOSTAVAX, but the product is currently on backorder. Merck will continue to release doses of ZOSTAVAX as supply becomes available, but as inventory is building, backorders will still occur. Timely information about the shipping times for ZOSTAVAX can be found at MerckVaccines.com. 5.3 Concurrent Illness FULL PRESCRIBING INFORMATION 19254 315 27 0.5 8.6% 19247 642 80 1.4 12.5% (7%, 59%) 60-69 5% 10370 122 8 0.3 6.6% 10356 334 23 0.7 6.9% (-107%, 56%) 70-79 55% 7621 156 12 0.5 7.7% 7559 261 45 2.0 17.2% (18%, 76%) >=80 26% 1263 37 7 1.9 18.9% 1332 47 12 3.1 25.5% (-69%, 68%) * PHN was defined as HZ-associated pain rated as >=3 (on a 0-10 scale), persisting or appearing more than 90 days after onset of HZ rash using Zoster Brief Pain Inventory (ZBPI)3. ** The table is based on the Modified Intent-To-Treat (MITT) population that included all subjects randomized in the study who were followed for at least 30 days postvaccination and did not develop an evaluable case of HZ within the first 30 days postvaccination. + Age strata at randomization were 60-69 and >=70 years of age. ++ Age-adjusted estimate based on the age strata (60-69 and >=70 years of age) at randomization. Talk to your health care provider if you plan to get ZOSTAVAX at the same time as the flu vaccine. Issued March 2011 Overall Study Cohort 255/18671 254/18717 1.01 (60 years of age and older) 1.4% 1.4% (0.85, 1.20) 60-69 years old 113/10100 101/10095 1.12 1.1% 1.0% (0.86, 1.46) 70-79 years old 115/7351 132/7333 0.87 1.6% 1.8% (0.68, 1.11) >=80 years old 27/1220 21/1289 1.36 2.2% 1.6% (0.78, 2.37) AE Monitoring Substudy Cohort 64/3326 41/3249 1.53 (60 years of age and older ) 1.9% 1.3% (1.04, 2.25) 60-69 years old 22/1726 18/1709 1.21 1.3% 1.1% (0.66, 2.23) 70-79 years old 31/1383 19/1367 1.61 2.2% 1.4% (0.92, 2.82) >=80 years old 11/217 4/173 2.19 5.1% 2.3% (0.75, 6.45) N=number of subjects in cohort with safety follow-up All rights reserved ZOSTAVAX is not indicated for prevention of primary varicella infection (Chickenpox) and should not be used in children and adolescents. Use only sterile syringes free of preservatives, antiseptics, and detergents for each injection and/or reconstitution of ZOSTAVAX. Preservatives, antiseptics and detergents may inactivate the vaccine virus. Administer ZOSTAVAX as a single 0.65-mL dose subcutaneously in the deltoid region of the upper arm. 11211 % % No. 4963-00 -- ZOSTAVAX is supplied as follows: (1)a package of 1single-dose vial of lyophilized vaccine, NDC 0006-4963-00 (packageA); and (2)a separate package of 10vials of diluent (packageB). 30 1 INDICATIONS AND USAGE *Sections or subsections omitted from the full prescribing information are not listed. Reconstitution: Visceral complications reported by fewer than 1% of subjects with zoster included 3 cases of pneumonitis and 1case of hepatitis in the placebo group, and 1case of meningoencephalitis in the vaccine group. % Before reconstitution, ZOSTAVAX SHOULD BE STORED FROZEN at a temperature between -58F and +5F (-50C and -15C) until it is reconstituted for injection. Any freezer, including frost-free, that has a separate sealed freezer door and reliably maintains a temperature between -58F and +5F (-50C and -15C) is acceptable for storing ZOSTAVAX. ZOSTAVAX is a live, attenuated varicella-zoster vaccine and administration may result in disseminated disease in individuals who are immunosuppressed or immunodeficient. Do not administer ZOSTAVAX to immunosuppressed or immunodeficient individuals including those with a history of primary or acquired immunodeficiency states, leukemia, lymphoma or other malignant neoplasms affecting the bone marrow or lymphatic system, AIDS or other clinical manifestations of infection with human immunodeficiency viruses, and those on immunosuppressive therapy. Do not administer ZOSTAVAX to pregnant women. It is not known whether ZOSTAVAX can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. However, naturally occurring VZV infection is known to sometimes cause fetal harm. Therefore, ZOSTAVAX should not be administered to pregnant women, and pregnancy should be avoided for 3 months following administration of ZOSTAVAX. 7 DRUG INTERACTIONS ZOSTAVAX is a lyophilized preparation of the Oka/Merck strain of live, attenuated varicella-zoster virus (VZV). ZOSTAVAX, when reconstituted as directed, is a sterile suspension for subcutaneous administration. Each 0.65-mL dose contains a minimum of 19,400PFU (plaque-forming units) of Oka/Merck strain of VZV when reconstituted and stored at room temperature for up to 30minutes. FDA EXPANDS INDICATION FOR ZOSTAVAX, MERCK'S SHINGLES VACCINE, TO INCLUDE ADULTS AGES 50 TO 59 16 HOW SUPPLIED/STORAGE AND HANDLING About Merck 8.3 Nursing Mothers ZOSTAVAX is contraindicated in: persons with a history of anaphylactic or anaphylactoid reaction to gelatin, neomycin, or any other component of the vaccine; persons with a history of primary or acquired immunodeficiencies; persons on immunosuppressive therapy; pregnant women or women of childbearing age. Table 3 Injection-Site Adverse Reactions* in >=1% of Adults Who Received ZOSTAVAX or Placebo Within 5 Days Postvaccination from the AE Monitoring Substudy of the Shingles Prevention Study The median duration of clinically significant pain (defined as >=3 on a 0-10 point scale) among HZ cases in the group of subjects who received ZOSTAVAX as compared to the group of subjects who received placebo was 20 days vs. 22 days based on the confirmed HZ cases. ZOSTAVAX In the ZEST study, all subjects were monitored for adverse reactions. An anaphylactic reaction was reported for one subject vaccinated with ZOSTAVAX. Serious Adverse Events Occurring Over the Entire Course of the Study 14.3 Concomitant Use Studies Initial U.S. Approval: 2006 All rights reserved http://www.businesswire.com/news/home/20110324006808/en/ADDING-REPLACINGFDA-Expands-Indication-ZOSTAVAX-Mercks-Shingles 6 ADVERSE REACTIONS Issued March 2011 7.1 Concomitant Administration with Other Vaccines DOSAGE AND ADMINISTRATION Age group (yrs.) ZOSTAVAX is not indicated for the treatment of zoster or postherpetic neuralgia (PHN). ZOSTAVAX is not indicated for prevention of primary varicella infection (Chickenpox). General disorders and administration site conditions: injection-site rash; pyrexia; injection-site urticaria; transient injection-site lymphadenopathy Tell your health care provider if you expect to be in close contact (including household contact) with newborn infants, someone who may be pregnant and has not had chickenpox or been vaccinated against chickenpox, or someone who has problems with their immune system. Your health care provider can tell you what situations you may need to avoid. Dist. by: Merck Sharp & Dohme Corp., a subsidiary of MERCK & CO., INC., Whitehouse Station, NJ 08889, USA (95% CI) Following FDA approval the next step is a vote by the CDC's Advisory Committee on Immunization Practices (ACIP) on whether to recommend administration of ZOSTAVAX for use in people ages 50 to 59. Merck anticipates that the ACIP will vote on use of ZOSTAVAX in this population later this year. Some managed care companies may decide to provide reimbursement for ZOSTAVAX for adults ages 50 to 59 prior to the ACIP's vote; however, many insurance companies typically await the ACIP's vote before making a coverage determination. ZOSTAVAX (Zoster Vaccine Live) Zoster Vaccine Live # subjects # HZ cases # PHN cases Incidence rate of PHN per 1,000 person-yrs. 5.2 Transmission of Vaccine Virus 2.1 Recommended Dose and Schedule 5.3 Concurrent Illness Transmission of vaccine virus may occur between vaccinees and susceptible contacts. Each dose contains 31.16mg of sucrose, 15.58mg of hydrolyzed porcine gelatin, 3.99mg of sodium chloride, 0.62mg of monosodium L-glutamate, 0.57mg of sodium phosphate dibasic, 0.10mg of potassium phosphate monobasic, 0.10mg of potassium chloride; residual components of MRC-5 cells including DNA and protein; and trace quantities of neomycin and bovine calf serum. The product contains no preservatives. Single 0.65 mL subcutaneous injection (2.1) ZOSTAVAX is given as a single dose by injection under the skin. CURRENT CIRCULAR SHOWING REVISIONS COMMENTS / SUPPORT FDA approval first step to increasing access to ZOSTAVAX for adults 50 to 59 Forward-Looking Statement Fifty-one individuals (1.5%) receiving ZOSTAVAX were reported to have congestive heart failure (CHF) or pulmonary edema compared to 39 individuals (1.2%) receiving placebo in the AE Monitoring Substudy; 58 individuals (0.3%) receiving ZOSTAVAX were reported to have congestive heart failure (CHF) or pulmonary edema compared to 45 (0.2%) individuals receiving placebo in the overall study. have or have had any medical problems. take any medicines, including non-prescription medicines, and dietary supplements. have any allergies, including allergies to neomycin or gelatin. had an allergic reaction to another vaccine. are pregnant or plan to become pregnant. are breast-feeding. Shingles is a painful disease that can be debilitating 5.2 Transmission of Vaccine Virus Vaccine Efficacy (95% CI) % In Merck's ZOSTAVAX Efficacy and Safety Trial (ZEST), a randomized, double-blind, placebo-controlled study in adults who were 50 to 59 years of age at the time of vaccination, 11,184 volunteers received ZOSTAVAX and 11,212 received placebo. Study participants were monitored for the development of shingles for a median of 1.3 years (range 0 to 2 years) after receiving vaccination. Participants also were followed for adverse events (AEs) for 42 days postvaccination and for serious adverse events (SAEs) through six months postvaccination. Overall, the benefit of ZOSTAVAX in the prevention of PHN can be primarily attributed to the effect of the vaccine on the prevention of herpes zoster. Vaccination with ZOSTAVAX in the SPS reduced the incidence of PHN in individuals 70 years of age and older who developed zoster postvaccination. Other prespecified zoster-related complications were reported less frequently in subjects who received ZOSTAVAX compared to subjects who received placebo. Among HZ cases, zoster-related complications were reported at similar rates in both vaccination groups (Table 7). 14.2 Shingles Prevention Study (SPS) in Subjects 60 Years of Age and Older See 17 for PATIENT COUNSELING INFORMATION and FDA-Approved Patient Labeling. Placebo Contraindications, Pregnancy (4.3) 03/2011 7.1 Concomitant Administration with Other Vaccines 15 REFERENCES A reduced immune response to ZOSTAVAX was observed in individuals who received concurrent administration of PNEUMOVAX23 (Pneumococcal Vaccine Polyvalent) and ZOSTAVAX compared with individuals who received these vaccines 4 weeks apart. Consider administration of the two vaccines separated by at least 4 weeks. Placebo The most frequent adverse reactions, reported in >=1% of subjects vaccinated with ZOSTAVAX, were headache and injection-site reactions (6). 5.1 Hypersensitivity Reactions 6.3 Postmarketing Experience Who should not get ZOSTAVAX? (n = 659) % Among (N = 3271) Vaccine efficacy against PHN in subjects who develop HZ postvaccination (95% CI) 4.1 Hypersensitivity Immune responses to vaccination were evaluated in a random 10% subcohort (n=1,136 for ZOSTAVAX and n=1,133 for placebo) of the subjects enrolled in the ZEST study. VZV antibody levels (Geometric Mean Titers, GMT), as measured by glycoprotein enzyme-linked immunosorbent assay (gpELISA) 6 weeks postvaccination, were increased 2.3-fold [95% CI (2.2, 2.4)] in the group of subjects who received ZOSTAVAX compared to subjects who received placebo; the specific antibody level that correlates with protection from zoster has not been established. ZOSTAVAX Efficacy and Safety Trial (ZEST) in Subjects 50 to 59 Years of Age You should not get ZOSTAVAX if you: ZOSTAVAX (pronounced "ZOS tah vax") 5.1 Hypersensitivity Reactions Can I get ZOSTAVAX with other vaccines? Revised: 03/2011 12 CLINICAL PHARMACOLOGY For concomitant administration of ZOSTAVAX with trivalent inactivated influenza vaccine, [see Clinical Studies (14.3)]. 3 DOSAGE FORMS AND STRENGTHS What are the possible side effects of ZOSTAVAX? Zoster Cases 5.4 Limitations of Vaccine Effectiveness ZOSTAVAX 12 CLINICAL PHARMACOLOGY The following factors, among others, could cause actual results to differ from those set forth in the forward-looking statements: the possibility that the expected synergies from the merger of Merck and Schering-Plough will not be realized, or will not be realized within the expected time period; the impact of pharmaceutical industry regulation and health care legislation; the risk that the businesses will not be integrated successfully; disruption from the merger making it more difficult to maintain business and operational relationships; Merck's ability to accurately predict future market conditions; dependence on the effectiveness of Merck's patents and other protections for innovative products; the risk of new and changing regulation and health policies in the U.S. and internationally and the exposure to litigation and/or regulatory actions. Adverse Reaction In the AE Monitoring Substudy, the rate of SAEs was increased in the group of subjects who received ZOSTAVAX as compared to the group of subjects who received placebo (Table 2). The overall incidence of systemic adverse experiences reported during Days 1-42 was higher for ZOSTAVAX (35.4%) than for placebo (33.5%). 14.1 ZOSTAVAX Efficacy and Safety Trial (ZEST) in Subjects 50 to 59 Years of Age 12.1 Mechanism of Action 5 WARNINGS AND PRECAUTIONS ZOSTAVAX is a registered trademark of Merck & Co., Inc., Whitehouse Station, N.J., USA There was an overall higher incidence of AEs in the vaccine group versus the placebo group; this difference was primarily due to different rates of injection-site AEs (63.6 percent for vaccine vs. 14.0 percent for placebo). The overall incidence of systemic adverse experiences reported within 42 days of vaccination was higher for ZOSTAVAX than for placebo (35.4 percent for vaccine vs. 33.5 percent for placebo); however, no significant differences were observed between the two study groups for any individual systemic AEs with the exception of pain in the extremity and headache. Serious adverse events (SAE) occurred at a similar rate in subjects vaccinated with ZOSTAVAX or placebo within 42 days of vaccination (0.6 percent for vaccine vs. 0.5 percent for placebo) and 182 days of vaccination (2.1 percent for vaccine vs. 1.9 percent for placebo). An anaphylactic reaction was reported for one study participant who received ZOSTAVAX. Hypersensitivity reactions including anaphylaxis have occurred with ZOSTAVAX (5.1) Transmission of vaccine virus may occur between vaccinees and susceptible contacts (5.2) Avoid pregnancy for 3 months following vaccination with ZOSTAVAX (8.1) Deferral should be considered in acute illness (for example, in the presence of fever) or in patients with active untreated tuberculosis (5.3) 13.1 Carcinogenesis, Mutagenesis, Impairment of Fertility Single dose vials with not less than 19,400 plaque-forming units [PFU] per 0.65 mL dose when reconstituted to a suspension. (2.1, 3, 16) 9989113 Zoster Vaccine Live 9989113 The re-issued release reads: ZOSTAVAX works by helping your immune system protect you from getting shingles. 4.1 Hypersensitivity The following adverse experiences in the AE Monitoring Substudy of the SPS (Days 0 to 42 postvaccination) were reported at an incidence >=1% and greater in subjects who received ZOSTAVAX than in subjects who received placebo, respectively: respiratory infection (65 [1.9%] vs. 55 [1.7%]), fever (59 [1.8%] vs. 53 [1.6%]), flu syndrome (57 [1.7%] vs. 52 [1.6%]), diarrhea (51 [1.5%] vs. 41 [1.3%]), rhinitis (46 [1.4%] vs. 36 [1.1%]), skin disorder (35 [1.1%] vs. 31 [1.0%]), respiratory disorder (35 [1.1%] vs. 27 [0.8%]), asthenia (32 [1.0%] vs. 14 [0.4%]). Indications and Usage (1) 03/2011 DO NOT FREEZE RECONSTITUTED VACCINE. CONTRAINDICATIONS # subjects # HZ cases Incidence rate of HZ per 1000 person-yrs. 6.2 VZV Rashes Following Vaccination Call 1-800-986-8999 to report any exposure to ZOSTAVAX during pregnancy. Table 4 Efficacy of ZOSTAVAX on HZ Incidence Compared with Placebo in the ZOSTAVAX Efficacy and Safety Trial+ Immune responses to vaccination were evaluated in a subset of subjects enrolled in the Shingles Prevention Study (N=1,395). VZV antibody levels (Geometric Mean Titers, GMT), as measured by glycoprotein enzyme-linked immunosorbent assay (gpELISA) 6 weeks postvaccination, were increased 1.7-fold (95% CI: [1.6 to 1.8]) in the group of subjects who received ZOSTAVAX compared to subjects who received placebo; the specific antibody level that correlates with protection from zoster has not been established. Children should not get ZOSTAVAX. Age group** (yrs.) Do not administer ZOSTAVAX to individuals with a history of anaphylactic/anaphylactoid reaction to gelatin, neomycin or any other component of the vaccine. Neomycin allergy manifested as contact dermatitis is not a contraindication to receiving this vaccine.1 The duration of protection beyond 4 years after vaccination with ZOSTAVAX is unknown. The need for revaccination has not been defined. Talk to your health care provider if you plan to get ZOSTAVAX at the same time as PNEUMOVAX 23 because it may be better to get these vaccines at least 4 weeks apart. Reporting Adverse Events The U.S. Department of Health and Human Services has established a Vaccine Adverse Event Reporting System (VAERS) to accept all reports of suspected adverse events after the administration of any vaccine. For information or a copy of the vaccine reporting form, call the VAERS toll-free number at 1-800-822-7967or report online to www.vaers.hhs.gov.2 allergic reactions, which may be serious and may include difficulty in breathing or swallowing. If you have an allergic reaction, call your doctor right away. fever hives at the injection site joint pain muscle pain rash rash at the injection site swollen glands near the injection site (that may last a few days to a few weeks) Systemic adverse reactions and experiences reported during Days 1-42 at an incidence of >=1% in either vaccination group were headache (ZOSTAVAX 9.4%, placebo 8.2%) and pain in the extremity (ZOSTAVAX 1.3%, placebo 0.8%), respectively. Zoster Cases 6.1 Clinical Trials Experience These highlights do not include all the information needed to use ZOSTAVAX safely and effectively. See full prescribing information for ZOSTAVAX. Serious Adverse Events Occurring 0-42 Days Postvaccination The numbers of subjects with elevated temperature (>=38.3C [>=101.0F]) within 42 days postvaccination were similar in the ZOSTAVAX and the placebo vaccination groups [27 (0.8%) vs. 27 (0.9%), respectively]. Broad managed care coverage for ZOSTAVAX for adults 60 and older In a double-blind, controlled clinical trial, 473 adults, 60 years of age or older, were randomized to receive ZOSTAVAX and PNEUMOVAX 23 concomitantly (N=237), or PNEUMOVAX 23 alone followed 4 weeks later by ZOSTAVAX alone (N=236). At four weeks postvaccination, the VZV antibody levels following concomitant use were significantly lower than the VZV antibody levels following nonconcomitant administration (GMTs of 338 vs. 484 gpELISA units/mL, respectively; GMT ratio = 0.70 (95% CI: [0.61, 0.80]). (n = 321) % Among 17 PATIENT COUNSELING INFORMATION 11228 Suspected HZ cases were followed prospectively for the development of HZ-related complications. Table 6 compares the rates of PHN defined as HZ-associated pain (rated as 3 or greater on a 10-point scale by the study subject and occurring or persisting at least 90 days) following the onset of rash in evaluable cases of HZ. # subjects # HZ cases Incidence rate of HZ per 1000 person-yrs. Efficacy of ZOSTAVAX was evaluated in the ZOSTAVAX Efficacy and Safety Trial (ZEST),a placebo-controlled, double-blind clinical trial in which 22,439 subjects 50 to 59 years of age were randomized to receive a single dose of either ZOSTAVAX (n=11,211) or placebo (n=11,228). Subjects were followed for the development of zoster for a median of 1.3 years (range 0 to 2 years). Confirmed zoster cases were determined by Polymerase Chain Reaction (PCR) [86%] or, in the absence of virus detection, by a Clinical Evaluation Committee [14%]. The primary efficacy analysis included all subjects randomized in the study (intent-to-treat [ITT] analysis). Merck undertakes no obligation to publicly update any forward-looking statement, whether as a result of new information, future events or otherwise. Additional factors that could cause results to differ materially from those described in the forward-looking statements can be found in Merck's 2010 Annual Report on Form 10-K and the company's other filings with the Securities and Exchange Commission (SEC) available at the SEC's Internet site (www.sec.gov). You should tell your health care provider if you: How is ZOSTAVAX given? Vaccinees and health care providers are encouraged to report any exposure to ZOSTAVAX during pregnancy by calling 1-800-986-8999. Solicited* Pain 53.9 9.0 Erythema 48.1 4.3 Swelling 40.4 2.8 Unsolicited Pruritis 11.3 0.7 Warmth 3.7 0.2 Hematoma 1.6 1.6 Induration 1.1 0.0 *Solicited on the Vaccination Report Card Among reported serious adverse events in the SPS (Days 0 to 42 postvaccination), serious cardiovascular events occurred more frequently in subjects who received ZOSTAVAX (20 [0.6%]) than in subjects who received placebo (12 [0.4%]) in the AE Monitoring Substudy. The frequencies of serious cardiovascular events were similar in subjects who received ZOSTAVAX (81 [0.4%]) and in subjects who received placebo (72 [0.4%]) in the entire study cohort (Days 0 to 42 postvaccination). Pain associated with zoster may occur during the prodrome, the acute eruptive phase, and the postherpetic phase of the infection. Pain occurring in the postherpetic phase of infection is commonly referred to as postherpetic neuralgia (PHN). n/N ZOSTAVAX cannot be used to treat shingles, or the nerve pain that may follow shingles, once you have it. Table 7 Relative Risk 2. Atkinson WL, Pickering LK, Schwartz B, Weniger BG, Iskander JK, Watson JC. General recommendations on immunization: Recommendations of the Advisory Committee on Immunization Practices (ACIP) and the American Academy of Family Physicians (AAFP). MMWR 2002;51(RR02):1-36. 5.4 Limitations of Vaccine Effectiveness 9989113 When reconstituted, ZOSTAVAX is a semi-hazy to translucent, off-white to pale yellow liquid. What do I need to know about shingles and the virus that causes it? CURRENT CIRCULAR SHOWING REVISIONS COMMENTS / SUPPORT History of anaphylactic/anaphylactoid reaction to gelatin, neomycin, or any other component of the vaccine. (4.1) Immunosuppression or Immunodeficiency. (4.2) Pregnancy. (4.3, 8.1). Concurrent administration of ZOSTAVAX and antiviral medications known to be effective against VZV has not been evaluated. "This expanded indication is important for the health of people who are 50 and older because nearly everyone in that age group is at risk for developing shingles," said Jeffrey Silber, M.D., vice president, Merck Research Laboratories. "ZOSTAVAX can help to prevent this disease that can be painful and potentially debilitating for some people."

INDICATIONS AND USAGE ZOSTAVAX is not indicated for the treatment of shingles or postherpetic neuralgia (PHN) or for the prevention of chickenpox. ZOSTAVAX is contraindicated for individuals who are allergic to any of its ingredients, including gelatin or neomycin, have a weakened immune system, take high doses of steroids, or are pregnant or plan to become pregnant. Vaccination with ZOSTAVAX may not result in protection of all vaccine recipients. Pregnancy: Do not administer ZOSTAVAX to females who are pregnant. Animal reproduction studies have not been conducted. It is not known whether ZOSTAVAX can cause fetal harm. (4.3, 8.1) Pregnancy Registry Available - call 1-800-986-8999. Allodynia 135 42.1 310 47.0 Bacterial Superinfection 3 0.9 7 1.1 Dissemination 5 1.6 11 1.7 Impaired Vision 2 0.6 9 1.4 Ophthalmic Zoster 35 10.9 69 10.5 Peripheral Nerve Palsies (motor) 5 1.6 12 1.8 Ptosis 2 0.6 9 1.4 Scarring 24 7.5 57 8.6 Sensory Loss 7 2.2 12 1.8 N=number of subjects randomized n=number of zoster cases, including those cases occurring within 30 days postvaccination, with these data available * Complications reported at a frequency of >=1% in at least one vaccination group among subjects with zoster. In the SPS, all subjects were monitored for vaccine-related SAEs. Investigator-determined, vaccine-related serious adverse experiences were reported for 2 subjects vaccinated with ZOSTAVAX (asthma exacerbation and polymyalgia rheumatica) and 3subjects who received placebo (Goodpasture's syndrome, anaphylactic reaction, and polymyalgia rheumatica). n=number of subjects reporting an SAE 0-42 Days postvaccination are allergic to any of its ingredients. are allergic to gelatin or neomycin. have a weakened immune system (for example, an immune deficiency, leukemia, lymphoma, or HIV/AIDS). take high doses of steroids by injection or by mouth. are pregnant or plan to get pregnant. Today's Merck is a global healthcare leader working to help the world be well. Merck is known as MSD outside the United States and Canada. Through our prescription medicines, vaccines, biologic therapies, and consumer care and animal health products, we work with customers and operate in more than 140 countries to deliver innovative health solutions. We also demonstrate our commitment to increasing access to healthcare through far-reaching policies, programs and partnerships. For more information, visit www.merck.com. 4 CONTRAINDICATIONS 1 INDICATIONS AND USAGE ZOSTAVAX is not indicated in women who are nursing. It is not known whether VZV is secreted in human milk. Therefore, because some viruses are secreted in human milk, caution should be exercised if ZOSTAVAX is administered to a nursing woman. Active Ingredient: a weakened form of the varicella-zoster virus. Rates of hospitalization were similar among subjects who received ZOSTAVAX and subjects who received placebo in the AE Monitoring Substudy, throughout the entire study. MERCK & CO., INC., Whitehouse Station, NJ 08889, USA Vaccine Efficacy (95% CI) This news release includes "forward-looking statements" within the meaning of the safe harbor provisions of the United States Private Securities Litigation Reform Act of 1995. Such statements may include, but are not limited to, statements about the benefits of the merger between Merck and Schering-Plough, including future financial and operating results, the combined company's plans, objectives, expectations and intentions and other statements that are not historical facts. Such statements are based upon the current beliefs and expectations of Merck's management and are subject to significant risks and uncertainties. Actual results may differ from those set forth in the forward-looking statements. The following additional adverse reactions have been identified during postmarketing use of ZOSTAVAX. Because these reactions are reported voluntarily from a population of uncertain size, it is generally not possible to reliably estimate their frequency or establish a causal relationship to the vaccine. 4 CONTRAINDICATIONS % HZ cases with PHN ZOSTAVAX is a live attenuated virus vaccine indicated for prevention of herpes zoster (shingles) in individuals 50 years of age and older. (1) Prescribing information and patient product information for ZOSTAVAX(r) (Zoster Vaccine Live) are attached and are also available at http://www.merck.com/product/usa/pi_circulars/z/zostavax/zostavax_pi.pdf and http://www.merck.com/product/usa/pi_circulars/z/zostavax/zostavax_ppi.pdf. Overall 19254 315 5.4 19247 642 11.1 51% (44%, 58%) 60-69 10370 122 3.9 10356 334 10.8 64% (56%, 71%) 70-79 7621 156 6.7 7559 261 11.4 41% (28%, 52%) >=80 1263 37 9.9 1332 47 12.2 18% (-29%, 48%) * The analysis was performed on the Modified Intent-To-Treat (MITT) population that included all subjects randomized in the study who were followed for at least 30 days postvaccination and did not develop an evaluable case of HZ within the first 30 days postvaccination. ** Age strata at randomization were 60-69 and >=70 years of age. Solicited** Erythema 35.6 6.9 Pain/Tenderness 34.3 8.3 Swelling 26.1 4.5 Unsolicited Hematoma 1.6 1.4 Pruritis 6.9 1.0 Warmth 1.6 0.3 *Patients instructed to report adverse experiences on a Vaccination Report Card **Solicited on the Vaccination Report Card The CDC currently recommends a single dose of ZOSTAVAX for all appropriate people 60 years of age and older, regardless of whether they have had a prior case of shingles, noting that persons with chronic medical conditions may be vaccinated unless their condition constitutes a contraindication. The risk of developing zoster appears to be related to a decline in VZV-specific immunity. ZOSTAVAX was shown to boost VZV-specific immunity, which is thought to be the mechanism by which it protects against zoster and its complications. [See Clinical Studies (14).] ZOSTAVAX

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Builder Finds Author of Touching 60-Year-Old Santa Letter Left in Chimney

A British builder plans on reuniting a man with a letter he wrote and left for Santa Claus as a boy, inside a chimney, almost 60 years ago. "We plan on giving the note back," Lewis Shaw of Reading, England told ABC News today. "I think that note means something to him because that house [where we found the letter] is his family home." "We also got all the presents on the list and made up a box to give it to him," Shaw added. Lewis Shaw, 24, of Reading, England pictured with his fiance Gemma Blackburn. Shaw said the 60-year old letter to Santa Claus was discovered after he and his co-workers removed a chimney from the property they were renovating. Shaw, 24, said it was Monday on a job site in Caversham, England when he and his fellow workers came across a letter to Santa Claus as they removed a chimney during renovations. "The customer, she wanted to pull the chimney out of the room to make the room bigger," Shaw said. "We started taking it down, when two of my colleagues were cleaning up and they discovered a piece of paper that was folded up. That's when we discovered the letter." The note read: Dear Father Christmas,

Please can you send me Rupert Annual and a drum,box of chalk, soldiers and Indians, slippers, silk tie,pencil box, any little toys you have to spare. Love,David "I was http://home.howstuffworks.com/home-improvement/heating-and-cooling/clean-a-chimney.htm quite surprised," Shaw said. "It's not something you find everyday. The things he was asking for were very humble. He was asking for the things he needed in life, rather than the things he wanted. "It shocks me because obviously my generation and the kids of today, you expect the gifts you ask for like the games condole, the IPads, phones...compared to the toy soldiers and pencil box he wanted," he added. "Some Christmases I've seen [lists] 3 pages long these days. [It was] quite a personal thing that touched my heart and it everybody else who was working on the site." Shaw shared the note on Facebook where it eventually caught the attention of the local press, who connected him with its original author. Shaw said he plans to meet with David tomorrow to gift him with his letter and the items that he listed on it almost six decades ago. http://abcnews.go.com/Lifestyle/builder-finds-owner-touching-60-year-santa-letter/story?id=35693828

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Having One Can Save You Thousands by Jonathan Steele

Chimney caps protect the inside of the chimney, commonly called the liner. The moisture from rain and snow can cause the liner (or chimney if there is no liner) to break down prematurely. This process takes time, even years because the liner is so much thicker. So by putting it off, some day in the future, you will be faced with a major bill to replace the liner in your chimney. Have fun with your project.

If the liner does not come through the chimney top, then an additional top plate will be needed. Once it is installed then the cap will install in the same manner as above. They come in galvanized steel, painted galvanized steel and stainless steel. Unless your looking for decorative features, the stainless steel is perhaps the best value. It will virtually last the life of the house. How do you know what kind of cap you will need? Caps http://www.wikihow.com/Clean-Chimneys for chimneys come in many different styles and sizes. To determine what style is best for your application you will first need to know what kind of chimney you have. Many home centers sell chimney caps. Better prices can be found online. If you have a masonry chimney determine if you have a single flue or a multiple flue. With this information you will be ready to start shopping and saving. You will find this to be an easy job. Like insurance, you may never appreciate it till you need to use it. With this simple DIY chimney repair completed, you will save yourself from paying thousands of dollars in repairs. If you have a single clay liner sticking out of your masonry chimney, measure the top of the clay liner. These dimensions will determine what size cap will be needed. http://www.articlecity.com/articles/home_improvement/article_3598.shtml So when it comes time to sell your real estate investment, you may find your value is less than you hoped for the want of a simple repair. There is a more valuable risk you could be exposed to. The chimney damage that can come from the environment can adversely affect the health of you and your family. A cracked liner can allow dangerous gases to enter the home. In addition to fire risk, the gases can cause sever health problems. At other times they may move in when they discover the warmth. Unfortunately, they may be overcome by the gases and die a needless death. All of this can be prevented by the installation of a chimney cap. Did you know that a chimney cap costing between $80 and $125 can save you thousands of dollars. If you can work off a ladder, have basic handyman skills, and know how to operate a screw driver, then this is a DIY chimney repair job you can get on top of and save. Having a chimney cap can save you from another surprise. Many municipalities are requiring home owners to have one to pass inspection prior to the sale of the house. Home inspectors look at this as a sign that there may be hidden problems that need further checking. Problems that can be prevented with a chimney cap. An uncapped chimney also poses another problem. It is an open invitation to unwanted tenants moving in and settling down. These unwanted guests are of the winged and four legged variety. When they build their new summer home in your chimney, you may not notice until it becomes heating season. The visitors nests or habitation can block the chimney increasing the risk of a chimney fire. At the least, most home owners will not suspect this and have to pay for a service call to find out why the furnace does not work. If you have multiple clay liners coming out of the chimney top, you will need to determine the dimensions for a multi-flue cap. Any online or brick and mortar site will be able to help you fill your needs. To install, simply set the chimney cap over the terra-cotta chimney liner. Then tighten the screws (usually four) on each side equally.

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Chimney sweep likely prevents house fire in Kansas City

Note: The MCSC warns that most chimney fires go unnoticed by homeowners and damages by fire are found later by a chimney inspector. For more information about chimney safety visit www.chimkc.com or the Midwest Chimney Safety Council website at www.mcsc-net.org. The Midwest Chimney Safety Council recommends that a Level II internal camera inspection be performed annually by a CSIA Certified Chimney Sweep. On January 19, 2010 local chimney sweep Gene Padgitt found something odd while getting ready to install a woodburning insert in a 1920's Kansas City, Missouri home. Something that would likely have caused a house fire. The original builder of the home constructed an unlined chimney (a chimney without a clay tile flue liner) and put structural wood members inside the flue.

Gene Padgitt

Padgitt says that most of the fire hazards he sees having to do with the structure is wood framing placed right next to the exterior of the chimney chase. Code requires 1 clearance for exterior chimneys, and 2 clearance for interior chimneys, but this is http://www.thechimneysweep.com/ often ignored, even in newer homes. The location where it is the biggest problem is right above the opening of the fireplace in front of the smoke chamber, where the facial wall may hide internal combustible wood framing. Most of the house fires he sees start in this area. Wood chemically changes when exposed to heat over a period of time, allowing it to ignite at a much lower temperature than normal without direct flame. The ignition point of wood is normally 500 degrees, but pyrolized wood can ignite at temperatures as low as 180 degrees. Internal flue gas temperatures of fireplaces can reach up to 400 degrees, but if a chimney fire occurs the temperature will be much higher. Some chimney fires in field testing by the Midwest Chimney Safety Council have caused temperature readings of 2,100 - 2,800 degrees. A masonry chimney will continue to heat up after a chimney fire is out, causing a secondary fire hazard. Often, fire departments are called back to a house several hours after leaving due to combustibles igniting after they extinguished the fire. We see crazy things like this more often than most people realize, said Padgitt, who is also a State Certified Fire Investigator. People don't think about the inside of their chimney, and unless a professional chimney sweep inspects it, there is no way of knowing what the condition is. In this case, the house had been standing for 90 years without burning down, but the hazard was there and eventually would have been a serious problem. http://www.examiner.com/article/chimney-sweep-likely-prevents-house-fire-kansas-city After Padgitt saw the wood inside the chimney he told the homeowner he had to open up the brick chimney in the attic area to remove the combustibles. There, he found double 2 x 4's on one side and a header on the other side inside the chimney with brick built underneath and on top of the wood. Some of the wood had already been burned away by previous fires unknown to the homeowner, which probably smoldered but did not ignite due to lack of oxygen.

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Best Services For Garage Doors Repair Services In Palm Springs

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Alacritech Unveils Industry's Most Advanced Family of Microsoft TCP Chimney Offload Compatible Scalable Network Accelerators

SAN JOSE, Calif.--(BUSINESS WIRE)--Alacritech Inc., the leader of innovative data-delivery technology, today announced the broadest and most advanced family of Scalable Network Accelerators (SNAs) to offload TCP processing on Windows Server 2003 and Windows Storage Server 2003. Alacritech SNAs enable network servers to produce higher aggregate performance supporting more users, more storage and higher application performance. The innovative Dynamic TCP Offload technology has been natively integrated with Microsofts TCP Chimney Offload architecture, which is part of its Scalable Networking Pack for Windows Server 2003. In addition, Alacritech has unveiled a Scalable Storage Server Reference Design specifically for partners. As a key partner in Microsofts Scalable Networking initiative, Alacritech continues to deliver innovative TCP/IP offload technologies that help our customers cost-effectively embrace http://www.magic-sweep.com/ high-speed networking with Windows,said Mike Schutz, Director of Product Management for Windows Server Networking, Microsoft Corporation. Our Windows Server customers will benefit from the improved network application performance and scalability made possible through the combination of Microsofts TCP Chimney Offload architecture and Alacritechs latest Accelerators. Alacritech is targeting its enhanced offering at the fast growing Windows, Windows Server and Windows Storage Server segments where its SNAs can increase both file and block transport while achieving significant system scalability. Deploying Alacritechs Dynamic TCP Offload and SNAs results in fewer servers being required, meaning less capital, fewer licenses, fewer support requirements, and less power consumed. According to recent analyst reports, data will continue to explode with storage and server growth reaching 12 million units by 2010. Microsoft OS platforms are expected to dominate the market with 8 million units by 2010. As enterprises experience growth in data they are continually looking for solutions that allow increased server utilization, better network manageability and assurance that data latency will not impact business operations. Alacritech is clearly known for its innovation in the area of TCP Offload, and the fact that Microsoft has integrated Alacritechs model in TCP Chimney Offload speaks to its acceptance as a key Windows technology, said Arun Taneja, founder and analyst of The Taneja Group. The extensibility of Alacritechs Offload technology to NAS, including Windows Storage Server, makes a great deal of sense. They clearly understand the execution of Offload for both iSCSI and front-end file traffic and have the deep NAS systems expertise stemming from Larry and his design teams previous experience at Auspex to make them credible with the market and OEM partners. Alacritech 9.1 Drivers Support Microsoft TCP Chimney Offload Alacritechs SNA and iSNA products take advantage of Alacritechs new 9.1 Driver and provide full support for Microsoft TCP Chimney Offload with added support for Jumbo Frames and Teaming. The Exegy Ticker Plant processes and transmits financial data at extreme speeds to Wall Street customers whose businesses depend on split second decisions. The use of Alacritech accelerators has reduced our processing latency by 35 percent compared with other network interface cards, said Ronald Indeck, Founder and CTO at Exegy. Alacritech has clearly mastered TCP/IP Offload and our experience with the latest 9.1 Driver is further indication of that. Alacritech products fit well within the demanding world of video post-production, stated Dr. Meier, Chief Technology Officer, StarGate Films, Inc. We are very pleased with the results we are seeing from the new Alacritech 9.1 Driver that integrates seamlessly with TCP Chimney Offload and have clearly seen the performance advantages. The Alacritech team is a pleasure to deal with and works hard to learn the needs of our business and how they can help us. Alacritech Improves Server Optimization for Volume Server and Workstation Markets Nine new network and storage accelerators have been added to Alacritechs fourth generation SNAs. Alacritechs full-fledged SNAs are capable of accelerating both iSCSI and network traffic and the iSCSI Scalable Network Accelerators (iSNA) are capable of accelerating only iSCSI traffic. Both the SNA and iSNA can function as a standard NIC on the network, in addition to their respective acceleration functions. Alacritechs innovative approach in addressing the Windows Volume Server Market with its new SNA and iSNA products can certainly help take customers to the next level of network efficiency, and we are happy to partner with them to take these new products to market, said John Vossoughi, Sr. VP Computer Products Marketing, Bell Microproducts. Alacritech is addressing this fastest growing segment of the server market with a new offering that delivers a compelling value proposition. Alacritech is introducing six SNA products, the SEN1511XT, SEN1512XT and SEN1522ET for the Workstation segment and the SEN1811XT, SEN1812XT and SEN1822ET focused on the Volume Server segment. In addition, the Alacritech iSNA products are designed for the Volume Server segment and include the SES1811XT, SES1812XT, SES1822ET. Both the SNA and iSNA accelerators increase the speed, power and performance of servers and are ideally suited for applications where data transport across the network occurs frequently. Examples of such applications include File Serving, NAS, NFS, CIFS, web or HTTP traffic, video post production and backup. These application loads comprise a significant percentage of Windows server shipments. Alacritech Scalable Storage Server Reference Design Alacritechs Scalable Storage Server Reference Design is a purpose-built high-performance NAS solution designed to demonstrate the enhanced performance and scalability that Alacritech can provide to Microsoft Windows Storage Server OEM partners. Alacritech SNA and Dynamic TCP Offload technology are integral to the design, accelerating both file and block traffic and allowing platforms built on Microsoft Windows Storage Servers to scale to higher levels of performance. The physical reference design will be made available to OEM partners in May 2007. Alacritech is pleased to lead the industry in developing and delivering unprecedented system-level flexibility and functionality via its accelerator products, said Larry Boucher, Founder and CEO, Alacritech. Im especially pleased to see the widespread acceptance of Alacritechs Dynamic TCP Offload technology, including Microsofts support for it and its incorporation into TCP Chimney Offload. We are building an ecosystem of partnerships in this area, with the most recent being QLogic, that speaks well to both the future of Alacritech and the viability of a technology that solves real customer problems. Through our partnerships and license agreements, customers benefit from Alacritechs leading technology with enhanced server performance and efficiencies, resulting in tremendous savings in capital, power, personnel and licenses. Availability The new Alacritech SNA and iSNA Volume Server products and 9.1 Driver will be shipping and available on April 11, 2007. The Storage Server Reference Design will be available in May 2007. Workstation SNA products will be available Third Quarter, 2007. Please visit our website at www.alacritech.com for more information on Alacritechs Distribution partners. About Alacritech Alacritech is the leading provider of innovative technology that increases the speed, power and performance of servers, enabling a truly scalable network. Organizations that use Alacritech's proven technology are better able to reduce the burden of network processing on their server, scale to support more clients and applications, achieve higher performance and realize increased network utilization. For more information visit the Alacritech web site at www.alacritech.com or contact the company at info@alacritech.com http://www.businesswire.com/news/home/20070411005336/en/Alacritech-Unveils-Industrys-Advanced-Family-Microsoft-TCP

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ten tips for using a charcoal chimney

Although the chimneys are great at lighting charcoal there are helpful tips on their use that are not widely known. Some of these tips make using the chimney easier while others are very important for your safety. Do not use your chimney on your driveway. It is very common for people to light their chimneys on their driveway. This is a bad idea for three reasons. The least important is that the heat and ash can leave a circular stain on the driveway that must be pressure washed to be removed. The second least important reason is that after you dump the coals the area where the chimney was sitting is extremely hot and is a burn hazard to any pets or barefoot kids that might walk by. The most important reason why you should never light your chimney while it is sitting on your driveway is that sometimes the intense heat of the chimney will cause pockets of water inside the concrete to rapidly vaporize and expand. When this happens a small portion of your driveway literally explodes and sends little bits of concrete flying through the air.Dont light your chimney on the top grate of your grill. This is an extremely common rookie mistake with chimneys. If you use your top grill grate to light your charcoal by the time the coals are fully lit the top grate is often glowing hot. Not only will this warp and deform your cooking surface but now you have to find some heavily insulated gloves just so you can lift the top grate to pour your coals underneath. A better solution is to remember to light the chimney on the charcoal grate which sits below the top grate.Dont use newspaper. The majority of people who utilize charcoal chimneys light them with newspaper as it is almost always on hand. The downside to using newspaper is that it does not completely combust. If you use newspaper there will always be a pile of black ash and paper flecks left behind that is more than happy to fly through the air and get all over your food. A better solution is to use a starter cube. Weber makes and sells packs of white starter cubes that are made of very clean burning paraffin. You get all the flammability of newspaper with none of the ash residue. Unlike lighter fluid, the starter cubes leave no smell behind.Use your side burner: Many grilling fanatics will often have both a charcoal and a gas grill. Most of the gas grills manufactured today also come with a side burner that in reality rarely gets used. A great way to get some use out of the side burner is to use it to light the charcoal in your chimney. If possible, remove the small cooking grate above the burner to let the flames get closer to the coals. Place the charcoal loaded chimney directly over the side burner, light the burner and set it to High. This works just as well as newspaper or starter cubes and lets you finally find a use for that side burner you paid an extra $50 for.Wear gloves: Even though chimneys come with a heat resistant handle it is important to always wear a glove (cotton or leather, not nitrile or latex) when handling a hot chimney. The reason is that chimneys have a finite life. Chimneys typically only last one to two grilling seasons before the effects of the extreme heat they are exposed to finally break them down. It is not always obvious when the handle on the chimney will break. Even if it is obvious that the handle integrity has been compromised some people will still use it because they need it right now and figure they will replace it tomorrow. If you are not wearing a glove when the handle fails on a hot chimney you will suffer a severe burn. Get in the habit of wearing a glove, even if you think you dont need it.Watch your toes. This is a really important tip that I am still learning. When we grill it is pretty common to be wearing shorts, a t-shirt and flip-flops. I always light my https://en.wikipedia.org/wiki/Chimney_sweep chimney on a junky old grill and carry the hot coals to my good grill. If you are carrying a hot chimney remember that hot embers often fall out the bottom. If these embers land on your unprotected toes they will burn your foot. Trust me, it hurts.Remember its hot: It is important to remember that after you dump the hot coals from the chimney into your grill that your chimney is still very hot and will remain so for at least 15 minutes. Do not place this hot chimney in the grass, on a plastic table or any other flammable surface. Always assume the chimney is hot and only grab it by the handle.You dont have to fill: It is not always appropriate to completely fill your chimney with charcoal. If you are going to be cooking burgers and hotdogs on a 14 inch Weber Smokey Joe you might only need a quarter of a chimney of coals. If you are going to be cooking a beer can chicken on a 22 inch Weber Performer then you probably need a full chimney. It will take you a few tries to judge how much charcoal you really need but if you can figure this out you will end up using your charcoal much more efficiently.Use it as a grill: Although chimneys are not designed for this they can easily be utilized as a grill themselves. If you purchase a small cooking grate (A 14 inch replacement grate for a Smokey Joe would work great and is readily available) you can center this on top of a chimney full of hot coals. The area directly over the coals is going to be incredibly hot, much hotter than a normal grill will ever get. This is a great way to flash sear something like a piece of fresh tuna that you want grilled on the outside but still raw on the inside. This setup also works get for charring the flesh from bell peppers. Please exercise great care if you utilize this technique as this is not a manufacturer intended use of a charcoal chimney.Replace it: Chimneys are great but please remember that they are a consumable item. Just as you need to replace your grill brushes when they get too gunky you need to replace your chimney when it gets too rusty. A three year old rust bucket of a chimney is a hazard that could get you or someone near you hurt very badly. A new chimney is cheap; it should cost less than $20. Please dont hesitate to get a new one when your current one starts to show signs of deterioration. The last tip I will throw in for free because it is so important. When using a charcoal chimney always have a fire extinguisher nearby in case something does go wrong. I hope you find these hints useful and keep that you stay safe during your grilling adventures!

Getting better at lighting charcoal is a matter of having the right tools and using them properly. One great tool for lighting charcoal is a chimney starter. A chimney starter looks like an empty coffee can with a handle on the side and ventilation holes on the bottom. You place your charcoal inside the chimney and a highly flammable material (usually newspaper) underneath the chimney. You light the flammable material and the natural draft of the chimney draws the intense flames through the charcoal. Chimneys work extremely well and can be found quite easily in stores or online. http://www.infobarrel.com/ten_tips_for_using_a_charcoal_chimney

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Suspected Burglar Dies in California Resident's Chimney Video

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Now Playing: CIA Accidentally Leaves Explosive Material on a School Bus http://www.homeadvisor.com/task.Chimney-or-Fireplace-Clean-and-Inspect.40034.html src="http://a.abcnews.go.com/images/WNT/160401_wn_index1_16x9t_384.jpg" width="145" height="84"/>Now Playing: Heroic Virginia Trooper Remembered in Memorial Service

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http://abcnews.go.com/US/video/suspected-burglar-dies-california-residents-chimney-35488151

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Courtney Stodden wears a bikini as she straddles Santa (aka Doug Hutchison) in the snow

You might argue that this 'sins of the flesh' incongruity shouldn't bother the teenager, but she claims to be a devout Christian and revealed in a recent interview with Zap2it that her favourite book is The Bible. ByAmelia Proud Updated: 18:17 EST, 19 December 2011

Hidden almost completely by his Father Christmas costume, the man of an age who should know better posed with his semi-naked young bride in a series of troubling images. It's now clear, if it wasn't always, that Doug is her Santa of choice. It's usually heartening to see people getting into the Christmas spirit, be it the cheery flash of a novelty Snowman earring or the bigger gesture of hours spent at a soup kitchen, extra effort for Yuletide is always warmly regarded. The couple play on the image - again, one that for years has been benign, innocent and the font of happy memories - of the young girl sitting on Santa's knee. And she admits that her friends make fun of her for being: 'A little too sexual.'

Happiness: Courtney is grateful for her personal Santa, which is good because it's doubtful the real one will be visiting

Waving goodbye: Courtney and Doug's seasonal 'treat' is at an end, heaven knows what they have planned for Easter http://links.ezinemark.com/view/courtney-stodden-wears-a-bikini-as-she-straddles-santa-aka-doug-hutchison-in-the-snow-56d14b90116.html But for Christmas, the blonde has (of course) gone that one step further and stripped down to just a bikini; a metallic red two-piece to celebrate the birth of Christ. She told Zap2it that her husband is her celebrity crush and when asked what her choice of superpower would be, she replied: 'I would find it breathtaking to be able to feel what it's like to fly... Wait. I'm already flying - flying on the wings of love!' The pair were thrown out of a pumpkin patch in the run-up to Halloween for displays of heavy petting that were rendered X-rated thanks to Courtney's skimpy shorts and shirt.

Tis the Season: To subvert a benevolent childhood hero, if you're Doug Hutchison and Courtney Stodden, that is - the pair visited the Angeles National Forest in California on Friday to pose for these pictures Doug also stands behind his wife as she wiggles her bum in his direction, and then there are those straddling shots. But trust teen bride Courtney Stodden, 17, and her husband Doug Hutchison, 51, to take things too far as they jump on the festive bandwagon to flaunt their May to December relationship. About the only one not likely to give you nightmares is the image of Doug's Bad Santa handing presents to Stodden, the other poses ensure that you will jettison the usual cookies and milk this year, and then barricade the chimney.

He's behind you: Boo, hiss etc as Doug becomes more pantomime villain that philanthropic patriarch

I Saw Mommy Kissing Santa Claus: The effect is less creepy when Doug's beard slips down Hutchison, who is best remembered as the nasty prison officer in The Green Mile and creepy Eugene Tooms in The X Files, has brought a similarly macabre presence to http://www.ebay.com/sch/i.html?_nkw=chimney+sweep the benevolent, child-friendly figure of selfless devotion. However, Father Christmas isn't a religious icon and therefore free for the couple to denigrate with their smutty snow escapades, safe in the knowledge that they won't risk upsetting religious groups, just hundreds and thousands of innocent children.

Jingle belle: Devout Christian Courtney Stodden wears a bikini to celebrate the festive period

It's Christmas time, there's no need to be afraid: Oh yes there is, when Courtney and Doug are around Stodden has for days now been issuing lascivious come ons to Saint Nick on her Twitter, interspersed with excerpts from her favourite book, The Bible.

Finally, some gifts: Doug's Santa hands over some colour coordinated presents

Eyes full of tinsel and fire: Courtney blends in with her artfully posed gifts Stodden also revealed that she lives in seven inch stilettos from the moment she gets out of bed, even when she is hiking in Hollywood with her mother and dog.

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Synchrony Financial and Precision Door Service Introduce New Consumer Financing Program | Reuters

Synchrony Financial and Precision Door Service Introduce New Consumer Financing Program Financing options available for new garage doors, repairs and installations Synchrony Financial (NYSE:SYF), a premier consumer financial services company with 80 years of retail heritage, today announced a new, multi-year agreement to offer a credit card program for consumers to finance products and services of Precision Door Service. Precision Door Service sells, repairs and installs garage doors and garage door openers. The company was founded as a family business and today has more than 75 franchise-owned locations nationwide. Consumers will be able to access special financing options with a Synchrony Bank-issued credit card.* Were pleased to work with an industry leader like Precision Door Service that shares our passion for quality and customer service, said Glenn Marino, executive vice president and CEO, Payment Solutions, Synchrony Financial. Providing financing options further shows their commitment to customers, since our research shows that the availability of financing is important to consumers making major purchases. The availability of financing is important to consumers, according to Synchrony Financials Fourth Annual Major Purchase Consumer Study.** Seventy-five percent of Synchrony Bank cardholders in the home improvement sector surveyed said they always seek promotional financing when making a purchase, and 44% said they would go to another retailer, or not make a purchase at all, if financing were not available. We are excited about the opportunity to provide our customers https://evestflorida.com/find-a-contractor/ with the robust benefits offered by SynchronyFinancial through our new financing program agreement, said Bill Walden, president and COO of Precision Door Service. Ourcustomers will now have access to a host of flexible finance options offered by Synchrony, to accompany the best-in-the-industryproducts and services they have come to expect from our company. *Subject to terms and conditions **Synchrony Financials Fourth Annual 2015 Major Purchase Consumer Study, conducted by a third-party, reflects the average experience of consumers making purchases valued at $500+ in one of 13 categories, including Home Improvement. About Precision Door Service Beginning as a family business in the late 1980s, Precision Door Service organized as an informal partnership in 1997. With aspirations of building the best garage door company in America, the founders began a franchise program in 1999 that is designed for national expansion. Precision Door Service provides outstanding garage door repair service and installation, complete customer satisfaction, and a program that rewards excellence from our franchisees, technicians, and staff. We Fix Garage Doors Right! www.precisiondoor.net. About Synchrony Financial Synchrony Financial (NYSE: SYF) is one of the nations premier consumer financial services companies. Our roots in consumer finance trace back to 1932, and today we are the largest provider of private label credit cards in the United States based on purchase volume and receivables.*** We provide a range of credit products through programs we have established with a diverse group of national and regional retailers, local merchants, manufacturers, buying groups, industry associations and healthcare service providers to help generate growth for our partners and offer financial flexibility to our customers. Through our partners over 300,000 locations across the United States and Canada, and their websites and mobile applications, we offer our customers a variety of credit products to finance the purchase of goods and services. Synchrony Financial (formerly GE Capital Retail http://www.aladdindoors.com/garage-door-service/local.html Finance) offers private label and co-branded Dual Card credit cards, promotional financing and installment lending, loyalty programs and FDIC-insured savings products through Synchrony Bank. More information can be found at www.synchronyfinancial.com and twitter.com/SYFNews. ***Source: The Nilson Report (April, 2015, Issue # 1062) - based on 2014 data. 2015 Synchrony Bank/Synchrony Financial, All rights reserved.

View source version on businesswire.com: http://www.businesswire.com/news/home/20150902005747/en/ For Synchrony Financial 855-791-8007 media.relations@synchronyfinancial.com or For Precision Door Service Lisa Hurley, 608-828-4059 lisa.hurley@springswindowfashions.com

http://www.reuters.com/article/ct-synchrony-financial-idUSnBw025747a+100+BSW20150902

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Value Your Fireplace Investment -- Restore It Back To Life

Finding a qualified chimney sweep isn't an easy task. Pieces of bricks or stones may be found on the ground or about the roof, which can be an indication that there's a problem. If you are uncertain exactly what the refractory panels are, they are the slabs that sit within your fireplaces firebox. This article was posted on August 1, 2005. The robust light bars come having a smooth, UV resistant dome that can prevent dust from accumulating. These are virtually impervious to moisture penetration and lasts many years. Make certain that you have a circular saw having a diamond blade and enough panel material to replace the desired panels. Use this information to repair the necessary areas of the property and give it the TLC it deserves. This material has gone a considerable ways yet still has a fantastic potential to be employed for much more things. A solar light using a motion sensor assures the sunshine will come on only once someone is around, then automatically shut off after a period of non-movement. Price tags average from $100- $200. Related Articles. Our technicians at Lees Heating and Air are extremely knowledgeable and capable of service nearly every make and model o. An advanced LED light bar can have front facing, rear facing and side facing LED modules which can be independently controlled. If this inspection is not adequate, a Level III inspection may be necessary. What weaknesses have you discover? If YOU can see the problems, so will the potential buyers!. sales@ybdhc. The size the fireplace needs to be relative towards the size the room. While it's not the most serious repair, it does take extra some my company time and materials to complete. Make sure every one of the lights can be turned on easily. XML Sitemap. There are lots of chimney sweeps and hearth stores who do not have access to this license. JotulLennoxCentury Heating. Floorboards Sanding Together With Polishes Per Town By: ParthaG - Sanding is actually of importance to a new abrasive too as unattractive ground. 0010sExt Includes (0): 0. Lindemann Chimney Supply Now Providing Replacement Fireplace Refractory panels at Wholesale Pricing.

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Nabers Requirements

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