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This is VAERS ID 262847

Case Details

VAERS ID: 262847 (history)  
Form: Version 1.0  
Age: 25.0  
Gender: Female  
Location: Kentucky  
Vaccinated:2006-09-06
Onset:2006-09-06
   Days after vaccination:0
Submitted: 2006-09-11
   Days after onset:5
Entered: 2006-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0688F / 1 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2117AA / 1 RA / IM

Administered by: Private       Purchased by: Private
Symptoms: Erythema, Injection site warmth, Joint range of motion decreased, Pain, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: yearly examination
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: Patient said right deltoid area, became red, swollen, quarter size hard knot, achy, painful to raise arm. Knot was hot to touch.


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