Vaccine hesitancy has increased under the SARS-CoV-2 pandemic, with vaccine safety being the primary concern. Varicella Zoster Virus (VZV) infection is generally self-limiting in children, but can cause severe disease in adolescents, adults, and immunocompromised individuals. Live, attenuated VZV containing vaccines have been used for VZV prevention in the United States since 1996, is mandatory for military and healthcare workers and can induce vaccine-associated infection. Pre-clinical trials showed an incidence of vaccine-associated varicella in up to 5% of vaccine recipients, but was usually mild. We present a healthy 25-year-old female military healthcare worker who reported presumed varicella as a child but had demonstrated a negative titer. She received dose #1 of her varicella series per healthcare worker requirements and on day 12 she experienced fever, malaise, myalgia, chills, headache and onset of a new disseminated evolving varicella-like rash to include oral mucosal lesions. The lesions were confirmed as varicella via PCR. She was treated with antihistamines, NSAIDS, acetaminophen and valacyclovir. Evaluation supported immunocompetence, however she was symptomatic for more than 2 weeks. The case prompted further exploration of reported vaccine-associated varicella infection in adults. We performed a retrospective review of the Vaccine Adverse Events Reporting System (VAERS) via query of the CDC WONDER Database for varicella vaccine induced varicella infection in adults, with an onset within 0-30 days. All dates and both Varicella (Varivax) and MMRV(Proquad) were included. Cases with lesions limited to the injection site, more likely natural infection, tertiary transmission, an alternate diagnosis, or insufficient data to support event were excluded. The cases were analyzed by vaccine brand, demographics (age, sex), days to onset, lesion count and distribution, laboratory confirmation and rationale for receipt. Our VAERS query produced 118 reports dated 2001-2021; 15 cases were excluded and 103 were analyzed. The events were more common in females (58%), and persons 18-29 years old (41%). Onset was within 5 days for 29% of cases. Lesion description was present for 48% of reports and of these 90% were reported as more than one site or diffuse, or lesion count of at least 6 to more than 100. Only 14% of cases documented laboratory confirmation. Rationale for receipt could be discerned in only 31% of reports and of these only 16% were healthcare workers. Potential for a two-week duration illness following vaccine would be a valid concern, particularly since it would be unknown if the vaccine recipient would ever contract natural infection. Per pre-clinical trials, vaccine-associated varicella infection events are not rare. However, our CDC Wonder database query for vaccine-associated varicella produced only 103 cases in adults since the vaccine introduction. VAERS data has significant limitations, however, this small number of reports in the setting of millions of doses given annually is very reassuring. We conclude vaccine-associated varicella in adults is rare and that our case was atypically severe in a healthy adult.