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This is VAERS ID 276758

Case Details

VAERS ID: 276758 (history)  
Age: 15.0  
Gender: Female  
Location: Texas  
Vaccinated:2007-04-09
Onset:2007-04-10
   Days after vaccination:1
Submitted: 2007-04-18
   Days after onset:8
Entered: 2007-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 1213F / 0 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1424F / 0 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR 42158CA / 0 RA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0150F / 0 LA / SC

Administered by: Private       Purchased by: Private
Symptoms: Culture throat positive, Guttate psoriasis, Rash macular, Rash maculo-papular, Streptococcus identification test positive
SMQs:, Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: fever~Vaccine not specified (no brand name)~~0.00~Patient
Other Medications: Unknown
Current Illness: Acne
Preexisting Conditions:
Diagnostic Lab Data: Throat culture, 04/10/07, +, strep
CDC Split Type: WAES0704USA04271

Write-up: Patient returned to clinic within 24 hours of vaccination for macular rash on trunk. Macules approx 1-2 cm, annular. Pt did test (+) for strep and was diagnosed with gutate psoriasis vs vaccine rxn. This is in follow-up to report(s) previously submitted on 5/14/2007. Initial and follow up information has been received from a physician concerning a 15 year old female with acne, who on 09-APR-2007 at 1:00 pm was vaccinated with a first dose of GARDASIL (lot #654895/1424F) into the right arm IM. Concomitant therapy included VAQTA (lot # 656497/1213F) into the left arm IM, VARIVAX (lot # "0150F) into the left arm SC, and MENACTRA (lot # 42158CA) into the right arm IM. Within 24 hours, the patient experienced a diffuse maculopapular rash. On 10-APR-2007, the patient returned to the office and a strep test was positive for strep throat. The patient subsequently recovered from the strep throat and the maculopapular rash. Additional information has been requested.


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