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This is VAERS ID 276177

Case Details

VAERS ID: 276177 (history)  
Form: Version 1.0  
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 / 1 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1968AA / 1 LA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B011AA / 1 RA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0113U / 2 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
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: AMOXIL ALLERGY
Allergies:
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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