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This is VAERS ID 271470

Case Details

VAERS ID: 271470 (history)  
Form: Version 1.0  
Age: 12.0  
Gender: Female  
Location: California  
Vaccinated:2007-01-24
Onset:0000-00-00
Submitted: 2007-01-30
Entered: 2007-01-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U2310AA / 2 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0868F / 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2209AA / 1 RA / IM

Administered by: Military       Purchased by: Military
Symptoms: Injection site erythema, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

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: None
Current Illness: Seeing provider for eczema
Preexisting Conditions: eczema no allergies noted
Allergies:
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Child attended Karate class and instructor was tapping the injection not knowing that the child had received immunizations the day before. Red swollen the size of a baseball at site of injection on right deltoid. Area was tender to touch.


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