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This is VAERS ID 276177

Case Details

VAERS ID: 276177 (history)  
Age: 12.0  
Gender: Female  
Location: Ohio  
Vaccinated:2007-04-10
Onset:2007-04-11
   Days after vaccination:1
Submitted: 2007-04-12
   Days after onset:1
Entered: 2007-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0244U / 0 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1968AA / 0 LA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B011AA / 0 RA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0113U / 1 RA / SC

Administered by: Private       Purchased by: Private
Symptoms: Injection site erythema, Injection site induration
SMQs:, Extravasation events (injections, infusions and implants) (broad)

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

Write-up: area of erythema and induration at site of second varicella immunization. 9 by 4 cm. no fever


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