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This is VAERS ID 278398

Case Details

VAERS ID: 278398 (history)  
Age: 11.0  
Gender: Female  
Location: Georgia  
Vaccinated:2007-04-27
Onset:2007-05-01
   Days after vaccination:4
Submitted: 2007-05-02
   Days after onset:1
Entered: 2007-05-11
   Days after submission:9
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0188U / 0 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1968AA / 0 RA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C2644AA / - LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 01736 / 1 LA / SC

Administered by: Private       Purchased by: Private
Symptoms: Migraine, Sinusitis
SMQs:

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Received vaccines on 4-27-07 - varicella, Menactra, Tdap, Hep A, HPV. Dx with Sinusitis and migraine Type headache on 5-1-07. Returned to the office on 5-2-07 with probable migraine Dx.


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