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This is VAERS ID 279935

Case Details

VAERS ID: 279935 (history)  
Form: Version 1.0  
Age: 15.0  
Gender: Female  
Location: Illinois  
Vaccinated:2007-05-16
Onset:2007-05-17
   Days after vaccination:1
Submitted: 2007-05-21
   Days after onset:4
Entered: 2007-05-29
   Days after submission:8
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 1 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR 42223AA / 1 - / IM

Administered by: Public       Purchased by: Public
Symptoms: Induration, Pruritus, Skin warm
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: L arm developed large area of warm hard itchy (intense) induration


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