| VAERS ID: | 263220 | Vaccinated: | 2006-08-21 | | Age: | 22.0 | Onset: | 2006-08-21, Days after vaccination: 0 | | Gender: | Female | Submitted: | 2006-09-14, Days after onset: 24 | | Location: | Illinois | Entered: | 2006-09-19, Days after submission: 5 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: NONE | | Previous Vaccinations: | | Other Medications: ORTHO TRI CYCLEN | | Preexisting Conditions: CONCURRENT CONDITIONS: drug hypersensitivity | | CDC 'Split Type': WAES0608USA05414 | |