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This is VAERS ID 277687

Case Details

VAERS ID: 277687 (history)  
Age: 11.0  
Gender: Female  
Location: Minnesota  
Vaccinated:2007-04-23
Onset:2007-04-25
   Days after vaccination:2
Submitted: 2007-04-26
   Days after onset:1
Entered: 2007-05-01
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 03874 / 0 RA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B014BA / 0 RA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 03054 / - LA / SC

Administered by: Private       Purchased by: Private
Symptoms: Erythema, Pruritus, Skin warm, Swelling, Tenderness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: large area of erythema 4x4 cm central with 8-10 cm larger halo erythema with clearing between, very tender to touch, warm, mildly swollen-pruritic after varicella/2 days after shot


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