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This is VAERS ID 264556

Case Details

VAERS ID: 264556 (history)  
Age: 16.0  
Gender: Female  
Location: Indiana  
Vaccinated:2006-10-05
Onset:2006-10-05
   Days after vaccination:0
Submitted: 2006-10-13
   Days after onset:8
Entered: 2006-10-16
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U2239AA / 1 LA / -
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0223F / 1 LA / -
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 0 RA / -

Administered by: Private       Purchased by: Private
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)

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

Write-up: Pain in right upper arm from time of administration of vaccine and continuing 8 days.


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