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This is VAERS ID 278157

Case Details

VAERS ID: 278157 (history)  
Age: 13.0  
Gender: Female  
Location: Tennessee  
Vaccinated:2007-04-27
Onset:2007-04-27
   Days after vaccination:0
Submitted: 2007-04-30
   Days after onset:3
Entered: 2007-05-08
   Days after submission:8
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1426F / 0 RA / SC
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C2689AA / - RA / IM

Administered by: Private       Purchased by: Public
Symptoms: Ecchymosis, Erythema, Rash, Skin warm, Tenderness
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hypersensitivity (narrow), 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: Increased Wt. gain
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: 3/12" x 3/12" x 3" Red, circular rash in area of ecclymosisin center. Mild tenderness, and warmth.


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