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This is VAERS ID 282270

Case Details

VAERS ID: 282270 (history)  
Age: 11.0  
Gender: Female  
Location: Minnesota  
Vaccinated:2007-06-08
Onset:2007-06-08
   Days after vaccination:0
Submitted: 2007-06-13
   Days after onset:5
Entered: 2007-06-19
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0387U / 0 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2236AA / 0 RA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B007AA / 0 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0368U / 1 LA / SC

Administered by: Private       Purchased by: Other
Symptoms: Culture throat positive, Injection site inflammation, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: Throat culture for strep group A
CDC Split Type:

Write-up: Pruritic rash and immunization site inflammation - right arm 6/9/07 (vaccines 6/8/07)


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