| VAERS ID: | 264209 | Vaccinated: | 2006-09-27 | | Age: | 12.0 | Onset: | 2006-09-27, Days after vaccination: 0 | | Gender: | Female | Submitted: | 2006-10-02, Days after onset: 5 | | Location: | Unknown | Entered: | 2006-10-10, Days after submission: 8 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: NONE | | Diagnostic Lab Data: NONE | | Previous Vaccinations: | | Other Medications: | | Preexisting Conditions: NONE | | CDC 'Split Type': | |
