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This is VAERS ID 277698

Case Details

VAERS ID: 277698 (history)  
Form: Version 1.0  
Age: 18.0  
Gender: Female  
Location: North Carolina  
Vaccinated:2007-04-20
Onset:2007-04-23
   Days after vaccination:3
Submitted: 2007-04-25
   Days after onset:2
Entered: 2007-05-01
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (NO BRAND NAME) / UNKNOWN MANUFACTURER 1282E / 1 LA / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 03844 / 1 LA / -
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1947AA / 1 RA / UN
TDAP: TDAP (ADACEL) / SANOFI PASTEUR AC52B005CA / 1 RA / UN

Administered by: Private       Purchased by: Unknown
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? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: NC07038

Write-up: 8 cm x 8 cm area of eryth and induration Tdap 4-20-07


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