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This is VAERS ID 274457

Case Details

VAERS ID: 274457 (history)  
Age: 10.0  
Gender: Female  
Location: Louisiana  
Vaccinated:2007-03-12
Onset:2007-03-13
   Days after vaccination:1
Submitted: 2007-03-14
   Days after onset:1
Entered: 2007-03-21
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0960F / 1 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1312F / 1 LA / SC

Administered by: Private       Purchased by: Public
Symptoms: Erythema, Oedema peripheral, Skin warm
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: Arm red, warm, swollen 8cmx8cm.


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