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This is VAERS ID 274964

Case Details

VAERS ID: 274964 (history)  
Form: Version 1.0  
Age: 13.0  
Gender: Female  
Location: Minnesota  
Vaccinated:2007-03-16
Onset:2007-03-17
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2007-03-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 08005 / 1 - / IM

Administered by: Private       Purchased by: Other
Symptoms: Herpes zoster
SMQs:

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: None
Allergies:
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Herpes Zoster of R upper chest & shoulder


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