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This is VAERS ID 279127

Case Details

VAERS ID: 279127 (history)  
Age: 9.0  
Gender: Female  
Location: Pennsylvania  
Vaccinated:2007-04-26
Onset:2007-04-27
   Days after vaccination:1
Submitted: 2007-04-30
   Days after onset:3
Entered: 2007-05-21
   Days after submission:21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 1281F / 1 RA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0960F / 0 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0110U / 1 LA / SC

Administered by: Public       Purchased by: Public
Symptoms: Pruritus, 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? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: RN received call from school nurse, stating that client was in her office with a rash on the outer aspect of her B/L arms. Rash raised sl, not fluid filled, and itchy. RN called clients mother. Rash was noted 4/27/07 in arm, itchy and raised only located on B/L arms. Child did not see MD. Rash is now subsiding. Mother instructed to take child to MD if rash worsens.


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