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This is VAERS ID 274777

Case Details

VAERS ID: 274777 (history)  
Form: Version 1.0  
Age: 14.0  
Gender: Female  
Location: New York  
Vaccinated:2007-03-19
Onset:2007-03-20
   Days after vaccination:1
Submitted: 2007-03-21
   Days after onset:1
Entered: 2007-03-26
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB143BA / 1 RA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 01870 / 2 LA / IM
TD: TD ADSORBED (NO BRAND NAME) / SANOFI PASTEUR AC52B014AA / 6 RA / IM

Administered by: Private       Purchased by: Private
Symptoms: Rash erythematous, Rash generalised
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: rash-red spots with white centers all over.


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