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This is VAERS ID 273415

Case Details

VAERS ID: 273415 (history)  
Age: 16.0  
Gender: Female  
Location: Colorado  
Vaccinated:2006-11-08
Onset:0000-00-00
Submitted: 2007-03-05
Entered: 2007-03-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / SANOFI PASTEUR C2609AA / 0 RA / IM
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U2255AAA / 0 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 0 LA / IM

Administered by: Private       Purchased by: Private
Symptoms: Injection site pain, Injection site reaction, Pigmentation disorder
SMQs:, Extravasation events (injections, infusions and implants) (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Yaz, Celexa
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Received first vaccine on 11/08/2006 never reported it until 03/01/. Area where she got Gardasil injection and tender and Hypo-pigmented. Left Arm 32mm x 24 mm 11/08/2006 Right Arm 22 x 25 mm 01/08/2007


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