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This is VAERS ID 279081

Case Details

VAERS ID: 279081 (history)  
Age: 17.0  
Gender: Female  
Location: Nevada  
Vaccinated:2007-05-16
Onset:2007-05-17
   Days after vaccination:1
Submitted: 2007-05-21
   Days after onset:4
Entered: 2007-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB148AA / 0 RA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1426F / 0 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2226AA / 0 LA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B013AA / 0 RA / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Pruritus generalised, Rash
SMQs:, Anaphylactic reaction (broad), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None Known
Preexisting Conditions: None
Diagnostic Lab Data: None at this time
CDC Split Type:

Write-up: On 5/16/07 received Tdap, #1Hep A, #1HPV and MCV4. On 5/17/07 she felt itchy all over especially her neck area. On 5/18/07 she woke up with a itchy/painful rash from the neck down. Father denies any problems with previous immunizations. Denies ingesting or having contact with anything new. Father has appled Flucocinolone Acetonide 0.025% cream to the rash area a couple of times since it developed. Recommended MD and advised to stop using the Flucocinolone Acetonide 0.025% cream (it had not been prescribed). Father states that he is taking his son to their family doctor.


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