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This is VAERS ID 280085

Case Details

VAERS ID: 280085 (history)  
Form: Version 1.0  
Age: 12.0  
Gender: Female  
Location: California  
Vaccinated:2007-05-25
Onset:2007-05-27
   Days after vaccination:2
Submitted: 2007-05-30
   Days after onset:3
Entered: 2007-05-31
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB129AA / 2 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. ME0181U / 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2183AA / 1 RA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C2720AA / 1 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0337U / 2 LA / SC

Administered by: Public       Purchased by: Public
Symptoms: Pyrexia, Rash, Varicella
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), 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: Asthma
Allergies:
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Outbreak of Varicella illness-rash, low grade fever.


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