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This is VAERS ID 281386

Case Details

VAERS ID: 281386 (history)  
Age: 15.0  
Gender: Female  
Location: Texas  
Vaccinated:2007-05-07
Onset:2007-05-07
   Days after vaccination:0
Submitted: 2007-05-10
   Days after onset:3
Entered: 2007-06-12
   Days after submission:33
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 1281F / 0 RA / -
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1424F / 0 LA / -
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1239AA / 0 LA / -
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C2454AA / 5 RA / -

Administered by: Other       Purchased by: Private
Symptoms: Abdominal pain upper, Blood test normal, Headache, Injected limb mobility decreased, Injection site induration, Injection site swelling, Injection site warmth, Pain
SMQs:, Acute pancreatitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None per mom and Patient
Preexisting Conditions: Denied allergies
Diagnostic Lab Data: per moms description: Blood work to check for infection. Results reported as within normal limits.
CDC Split Type:

Write-up: 5/10/07 0830 in ER with swollen, hot hard rt deltoid with c/o excessive pain and unwillingness to use arm. Pain rated 8 on 1-10. Blood drawn. no infection noted. Warm packs and NSAID. 5/1107 0900 back in ER. "Twice as big" "hard", "head hurts", "stomach hurts", per mother. Augmentin and Hydrazine given. Approx 12" x 8" per mom. 5/14/07 called mom. Went to another ER, was prescribed steroids per mom, all better. Will follow up 5/18


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