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This is VAERS ID 281733

Case Details

VAERS ID: 281733 (history)  
Age: 11.0  
Gender: Female  
Location: Florida  
Vaccinated:2007-06-13
Onset:2007-06-14
   Days after vaccination:1
Submitted: 2007-06-13
   Days after onset:1
Entered: 2007-06-14
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0263U / 0 RA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B012AA / 0 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0453U / 1 LA / SC

Administered by: Private       Purchased by: Public
Symptoms: Erythema, Induration
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
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 2 inches diameter of redness and firmness located to left outer arm.


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