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This is VAERS ID 271559

Case Details

VAERS ID: 271559 (history)  
Form: Version 1.0  
Age: 14.0  
Gender: Female  
Location: Pennsylvania  
Vaccinated:2007-01-17
Onset:2007-01-25
   Days after vaccination:8
Submitted: 2007-01-31
   Days after onset:6
Entered: 2007-01-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 1 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1046F / 2 LA / SC

Administered by: Public       Purchased by: Private
Symptoms: Pruritus, Rash vesicular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Asmarx, Albuterol, Florim cream
Current Illness: NONE
Preexisting Conditions: Eczema, Asthma
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Started with signs of chicken pox 8 days after vaccine over entire back, neck, front, abdomen. No comitant symptoms no fever, no stomach symptoms, no pain, no cough, no runny nose, no sore throat. Positive puritis.


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