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This is VAERS ID 281918

Case Details

VAERS ID: 281918 (history)  
Form: Version 1.0  
Age: 17.0  
Gender: Female  
Location: Arizona  
Vaccinated:2007-06-05
Onset:2007-06-07
   Days after vaccination:2
Submitted: 2007-06-08
   Days after onset:1
Entered: 2007-06-15
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1424F / 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2115AA / 1 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0114U / 2 RA / SC

Administered by: Public       Purchased by: Public
Symptoms: Body temperature increased, Injection site erythema, Injection site pain, Injection site warmth, Pain
SMQs:, Neuroleptic malignant syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Back Pain, left side
Preexisting Conditions: NKDA
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient presented to the clinic with left upper arm redness (10x8cm), warm and tender. Temp=99.3 (ear). (2 days after administration). No treatment - Told to return if worsening redness and pain, or drainage noted.


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