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This is VAERS ID 268513

Case Details

VAERS ID: 268513 (history)  
Age: 14.0  
Gender: Female  
Location: Minnesota  
Vaccinated:2006-12-04
Onset:2006-12-05
   Days after vaccination:1
Submitted: 2006-12-06
   Days after onset:1
Entered: 2006-12-07
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0637F / 0 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2094AA / 0 LA / IM

Administered by: Private       Purchased by: Unknown
Symptoms: Injection site reaction, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms 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: NONE
Preexisting Conditions: Allergic to Septra
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: Local pruritic reaction at injection site without erythema, edema left deltoid.


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