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This is VAERS ID 273922

Case Details

VAERS ID: 273922 (history)  
Age: 12.0  
Gender: Female  
Location: Michigan  
Vaccinated:2007-03-05
Onset:2007-03-05
   Days after vaccination:0
Submitted: 2007-03-07
   Days after onset:2
Entered: 2007-03-14
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1424F / - RA / IM
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD) / MERCK & CO. INC. 1397F / - RA / SC
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C2720AA / - LA / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Body temperature increased, Fatigue, Pharyngolaryngeal pain, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: ZYRTEC
Current Illness: Vague RLQ abd pain
Preexisting Conditions: Depression, seasonal allergies
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: Six hours s/p injections developed fever, rash up right arm, right side of neck and face. Also developed sore throat in 24 hours. Temp = 102. Rash responded to Benadryl except for local injection sites. Is having RLQ pain but that started before injections. Generally feels fatigued as well. No rash on left arm.


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