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This is VAERS ID 270145

Case Details

VAERS ID: 270145 (history)  
Age: 20.0  
Gender: Female  
Location: New York  
Vaccinated:2006-11-20
Onset:2006-11-22
   Days after vaccination:2
Submitted: 2006-12-18
   Days after onset:26
Entered: 2007-01-08
   Days after submission:21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U2240A / 1 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / -
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2159A / 0 RA / IM

Administered by: Private       Purchased by: Unknown
Symptoms: Erythema, Flushing, 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: Nevacor, Birth control pills, Celexa, Clontin
Current Illness:
Preexisting Conditions: No known allergies
Diagnostic Lab Data:
CDC Split Type: 2006034630

Write-up: Initial report received from a health care professional in the USA on 12 December 2006. A 18 year old, female patient (with a medical history of no known allergies) developed a flushed, red and itchy face, 2 days after she received Fluzone (lot number U2240AA) intramuscularly in the left deltoid, Menactra (lot number U2159AA) intramuscularly in the right deltoid and Gardasil (lot number unknown) on 20 November 2006. On 24 November 2006, the patient called to reports red spots on hands. The patient did not have any illness at the time of the vaccination. She was treated with Benadryl. She was not seen at the doctor''s office and has moved. It was reported that she recovered.


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