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This is VAERS ID 272876

Case Details

VAERS ID: 272876 (history)  
Form: Version 1.0  
Age: 14.0  
Gender: Female  
Location: Unknown  
   Days after vaccination:0
Submitted: 2007-02-09
   Days after onset:1
Entered: 2007-02-22
   Days after submission:13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Unknown       Purchased by: Unknown
Symptoms: Burning sensation, Incorrect dose administered, Injection site erythema, Injection site pain, Injection site rash, Vaccination complication
SMQs:, Peripheral neuropathy (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Medication errors (narrow)

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: Ortho-tricyclen, Synthroid
Current Illness:
Preexisting Conditions: egg allergy
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: Patient received partial dose of vaccine in left deltoid due to defective syringe. Pt immediately complained of a burning sensation on her arm where the medication ran (down her arm) I cleansed her entire upper arm with alcohol-pt relieved little relief. The she stated it was sore at about a 2 inch radius from the injection site. Pt was discharged in mother''s care to monitor her. Pt''s mother was contacted around 10:00 am the next day-stated-evening of 02/08/07, pt had severe pain at site and gave 2 500mg doses of Acetaminophen to relieve pain. Mother stated site looked red and raised-similar to a bee sting reaction. She also stated it was gone upon waking and pt now only complaining of moderate site pain with little swelling and redness. Pt to return in 3 days for reevaluation.

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