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This is VAERS ID 281395

Case Details

VAERS ID: 281395 (history)  
Form: Version 1.0  
Age:   
Gender: Female  
Location: Arizona  
Vaccinated:2007-06-05
Onset:2007-06-06
   Days after vaccination:1
Submitted: 2007-06-07
   Days after onset:1
Entered: 2007-06-12
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 017146109 / 1 LA / -
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD) / MERCK & CO. INC. 42058AA / 1 LA / -
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0308U2109 / 2 RA / -

Administered by: Private       Purchased by: Public
Symptoms: Cold compress therapy, Injection site erythema, Injection site pain, Injection site pruritus, Injection site warmth
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:
Current Illness: none
Preexisting Conditions: asthma
Allergies:
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Warm, red, pruritic area 2x3" on Right deltoid. Tender to touch. Gave ice/melt on 20 minutes off 20 minutes.


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