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This is VAERS ID 279150

Case Details

VAERS ID: 279150 (history)  
Form: Version 1.0  
Age: 14.0  
Gender: Unknown  
Location: Georgia  
Vaccinated:2007-05-11
Onset:2007-05-12
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2007-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0389U / 1 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0445U / 2 RA / IM

Administered by: Private       Purchased by: Private
Symptoms: Injection site erythema, Injection site pain
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: Uses Flonase, Obar, Claritin for allergies
Current Illness:
Preexisting Conditions: Allergies
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 5/11/07 Received Varivax booster RA. On 5/12/07 woke up with small red, tender area at shot site. On 5/13/07 area 7-8 inches in diameter, very tender, raised red, areas. 5/14/07 area of redness decreased. Now erythema 2 inch diameter. Ice and Benadryl advised.


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