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This is VAERS ID 275823

Case Details

VAERS ID: 275823 (history)  
Age: 11.0  
Gender: Female  
Location: Michigan  
Vaccinated:2007-03-14
Onset:2007-03-23
   Days after vaccination:9
Submitted: 2007-03-26
   Days after onset:3
Entered: 2007-04-09
   Days after submission:14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0962F / 0 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1892AA / 0 LA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C2492BA / 0 RA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1149F / 1 LA / SC

Administered by: Public       Purchased by: Public
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type: MI2007009

Write-up: On 3/23/07, had "bump" with 2 smaller bumps" on labia. 3-24-07 another appeared, but ''first was almost gone" Referred to private physician.


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