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This is VAERS ID 276976

Case Details

VAERS ID: 276976 (history)  
Form: Version 1.0  
Age:   
Gender: Female  
Location: North Carolina  
Vaccinated:2007-04-13
Onset:2007-04-16
   Days after vaccination:3
Submitted: 2007-04-16
   Days after onset:0
Entered: 2007-04-19
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 1282F / 1 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0384U / 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1947AA / 1 RL / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B065CA / 1 LL / IM

Administered by: Private       Purchased by: Private
Symptoms: Injection site erythema, Injection site induration, Injection site pain
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? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Lg, tender, erythematous area of approx 8x 11 cm with area of induration 6 x 7 cm, around site of Menactra vaccine. Tender area of eryth. and induration 3 x 6 cm of TDaP vaccine. Both vacc. given 3 days ago. Given Zyrtec 10 mg qd


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