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This is VAERS ID 271334

Case Details

VAERS ID: 271334 (history)  
Form: Version 1.0  
Age: 12.0  
Gender: Female  
Location: Arizona  
Vaccinated:2007-01-23
Onset:2007-01-24
   Days after vaccination:1
Submitted: 2007-01-26
   Days after onset:2
Entered: 2007-01-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 1209F / 2 RA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1424F / 1 GM / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2002AC / 1 GM / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C2689AA / 1 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1144F / 2 LA / SC

Administered by: Private       Purchased by: Private
Symptoms: Injection site erythema, Injection site inflammation, Injection site irritation, Injection site vesicles
SMQs:, Extravasation events (injections, infusions and implants) (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Gardasil was given in office. Pt. reported only some irritation at site following the administration of vaccine. The following day she developed local erythema and sm. blister. She was seen again in the office on 1/25/07. Superficial blister/inflammation of approx. 0.5 x 1.5cm was noted. No cellulitis noted. Area was lt. pink in color. Advised pt. to keep area clean and dry, apply antibiotic oint. if desired. Only local treatment needed. No further treatment anticipated.


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