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This is VAERS ID 281880

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

281880
VAERS Form:
Age:10.0
Gender:Female
Location:New Jersey
Vaccinated:2007-01-16
Onset:2007-01-17
Submitted:2007-05-16
Entered:2007-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - RA / UN
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1150F / 1 LA / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Body temperature increased, Injection site erythema, Injection site induration, Injection site pain, Injection site cellulitis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: body temp 01/17/07 102.5 F
CDC 'Split Type':

Write-up:Information has been received from a physician assistant concerning a 10 year old female with no allergies or medical history who on 22-APR-2002 was vaccinated with a first dose of Varivax without any problems and on 16-JAN-2007 was vaccinated SC in the l"eft deltoid with a 0.5 mL second dose of Varivax (lot # 654131/1150F). Concomitant vaccination on the same day included a dose of Gardasil in the other arm. There was no illness at the time of vaccination. On 17-JAN-2007, the patient developed an injectio


Changed on 12/8/2009

281880 Before After
VAERS Form:
Age:10.0
Gender:Female
Location:New Jersey
Vaccinated:2007-01-16
Onset:2007-01-17
Submitted:2007-05-16
Entered:2007-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - RA / UN
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1150F / 1 LA / SC

Administered by: Private      Purchased by: Unknown Private
Symptoms: Body temperature increased, Injection site erythema, Injection site induration, Injection site pain, Injection site rash, Injection site warmth, Pyrexia, Injection site cellulitis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: body temp 01/17/07 102.5 F
CDC 'Split Type': (blank) WAES0701USA03067

Write-up:Information has been received from a physician assistant concerning a 10 year old female with no allergies or medical history who on 22-APR-2002 was vaccinated with a first dose of Varivax without any problems and on 16-JAN-2007 was vaccinated SC in the l"eft left deltoid with a 0.5 mL second dose of Varivax (lot # 654131/1150F). Concomitant vaccination on the same day included a dose of Gardasil in the other arm. There was no illness at the time of vaccination. On 17-JAN-2007, the patient developed an injectio injection site rash. The rash was described as a cellulitis that was swollen, warm, and tender to the touch. The patient was seen in the office on 18-JAN-2007 and the cellulitis was determined to be 4 cm in diameter and reported to be larger than it was on 17-JAN-2007. The patient had a fever of 102 degrees Fahrenheit on 18-JAN-2007. Unspecified medical attention was sought and the patient was told to take Benadryl and to use a warm compress. No diagnostic laboratory tests were performed. At the time of the report the patient had not recovered. Follow-up information was received from the physician assistant who reported that on 17-JAN-2007, the patient had red, indurated, warm cellulitis of the left upper extremity around the injection site. It was greater than four inches in diameter with a central vesicle. Her temperature was 102.5. She was treated with Rocephin and Augmentin. The patient recovered on 19-JAN-2007. The patient''s experiences were considered to be disabling and other important medical events by the reporter. No further information is expected.


Changed on 9/14/2017

281880 Before After
VAERS Form:(blank) 1
Age:10.0
Gender:Female
Location:New Jersey
Vaccinated:2007-01-16
Onset:2007-01-17
Submitted:2007-05-16
Entered:2007-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UNK RA / UN
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1150F / 1 2 LA / SC

Administered by: Private      Purchased by: Private
Symptoms: Body temperature increased, Injection site erythema, Injection site induration, Injection site pain, Injection site rash, Injection site warmth, Pyrexia, Injection site cellulitis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: body temp 01/17/07 102.5 F
CDC 'Split Type': WAES0701USA03067

Write-up:Information has been received from a physician assistant concerning a 10 year old female with no allergies or medical history who on 22-APR-2002 was vaccinated with a first dose of Varivax without any problems and on 16-JAN-2007 was vaccinated SC in the left deltoid with a 0.5 mL second dose of Varivax (lot # 654131/1150F). Concomitant vaccination on the same day included a dose of Gardasil in the other arm. There was no illness at the time of vaccination. On 17-JAN-2007, the patient developed an injection site rash. The rash was described as a cellulitis that was swollen, warm, and tender to the touch. The patient was seen in the office on 18-JAN-2007 and the cellulitis was determined to be 4 cm in diameter and reported to be larger than it was on 17-JAN-2007. The patient had a fever of 102 degrees Fahrenheit on 18-JAN-2007. Unspecified medical attention was sought and the patient was told to take Benadryl and to use a warm compress. No diagnostic laboratory tests were performed. At the time of the report the patient had not recovered. Follow-up information was received from the physician assistant who reported that on 17-JAN-2007, the patient had red, indurated, warm cellulitis of the left upper extremity around the injection site. It was greater than four inches in diameter with a central vesicle. Her temperature was 102.5. She was treated with Rocephin and Augmentin. The patient recovered on 19-JAN-2007. The patient''s experiences were considered to be disabling and other important medical events by the reporter. No further information is expected.


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