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This is VAERS ID 267432

Case Details

VAERS ID: 267432 (history)  
Age: 13.0  
Gender: Female  
Location: California  
Vaccinated:2006-10-11
Onset:2006-10-11
   Days after vaccination:0
Submitted: 2006-11-14
   Days after onset:34
Entered: 2006-11-16
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0800F / - UN / UN
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / - UN / UN

Administered by: Private       Purchased by: Public
Symptoms: Hypoaesthesia, Injection site reaction
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Asthma, drug Hypersensitivity.
Diagnostic Lab Data: NONE
CDC Split Type: WAES0610USA09277

Write-up: Information has been received from a physician concerning a 12 year old female with asthma and Advair allergy who on 10/11/06 was vaccinated with HVP vaccine. Concomitant therapy that day included varicella virus vaccine and influenza vaccine. On 10/11/06 the pt experienced numbing at injection site and around arm. The pt recovered. Unspecified medical attention was sought. Additional information has been requested.


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