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This is VAERS ID 277199

Case Details

VAERS ID: 277199 (history)  
Age: 17.0  
Gender: Female  
Location: California  
Vaccinated:2007-04-13
Onset:2007-04-13
   Days after vaccination:0
Submitted: 2007-04-16
   Days after onset:3
Entered: 2007-04-23
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0263U / 0 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2002AC / 0 LA / IM

Administered by: Private       Purchased by: Other
Symptoms: Injection site erythema, Injection site induration, Injection site pruritus, Reaction to previous exposure to any vaccine
SMQs:, Extravasation events (injections, infusions and implants) (broad)

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

Write-up: 12 cm x 9 cm, red , hard, itchy area, around inj site on left arm-Old imm site (from Age 3-given in Foreign country) swelled up and go "bubbly".


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