National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 272340

Case Details

VAERS ID: 272340 (history)  
Form: Version 1.0  
Age: 11.0  
Gender: Female  
Location: California  
Vaccinated:2006-10-11
Onset:2006-10-11
   Days after vaccination:0
Submitted: 2007-02-14
   Days after onset:126
Entered: 2007-02-15
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 652809/1008F / UNK - / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 2 - / -
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2002AC / UNK - / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C2455AA / UNK - / IM

Administered by: Private       Purchased by: Private
Symptoms: Injection site anaesthesia, Injection site pain, Paraesthesia, Similar reaction on previous exposure to drug
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), 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: NONE
CDC Split Type: WAES0701USA02111

Write-up: Information has been received from registered nurse concerning a 11 year old female who on 11-OCT-2006 at 15:30, was vaccinated with the first dose of Gardasil (yeast) (lot number 654540/0800F) intramuscularly in the left deltoid. Concomitant vaccinations included hepatitis A vaccine (inactive) (MSD) (lot number 652809/1008F) intramuscularly in the right deltoid, meningococcal ACYW conj vaccine (MENACTRA) (lot number U2002AC) intramusculary in the right deltoid and (ADACEL) (lot number C2455AA) intramuscularly in the left deltoid. On 11-OCT-206 the patient stated that her arm tingled and felt numb at the injection site (arm not specified). Tingling and numbness lasted one hour. After that the patient stated the arm was just sore at the injection site. On 27-DEC-2006 was vaccinated with the second dose of Gardasil vaccine (yeast). On 27-DEC-2006 the patient again experienced arm tingled at injection site, but it "just lasted a few minutes". Additional information is not expected.


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=272340


Copyright © 2017 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166