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This is VAERS ID 280847

Case Details

VAERS ID: 280847 (history)  
Age: 19.0  
Gender: Female  
Location: Colorado  
Vaccinated:2007-05-29
Onset:2007-05-31
   Days after vaccination:2
Submitted: 2007-05-31
   Days after onset:0
Entered: 2007-06-07
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0243U / - LA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C2632AA / - LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0011N / 1 RA / SC

Administered by: Private       Purchased by: Private
Symptoms: Erythema, Pyrexia, Skin warm
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: local reaction~Measles + Mumps + Rubella (no brand name)~2~17.00~In Sibling
Other Medications: Flonase, Depakene, Tegretol, Duoneb, Singulair, Baclofen, Neurontin, Elavil, Oxygen, Miralax, Xopenex, Zyrtec, Pulmicort, Ibuprofen, Calcium Antacid tablets, Vitamin D tablet MSM with Glucosamine
Current Illness: Candidiasis
Preexisting Conditions: G Tube, Delayed milestones, spastic Quadriplegia, surgeries
Diagnostic Lab Data:
CDC Split Type:

Write-up: Vaccine MMR given 5/29/07 called 5/31/07 was was seen at pulmonologist office. Felt was more than just local reaction large hot red area back of right arm fever 101, cold compresses Ibuprofen, Keflex


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