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This is VAERS ID 283082

Case Details

VAERS ID: 283082 (history)  
Age: 11.0  
Gender: Female  
Location: Washington  
Vaccinated:2007-06-12
Onset:2007-06-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2007-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 00014U / 0 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0171U / 0 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2115AA / 0 RA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B015BA / 0 RA / IM

Administered by: Private       Purchased by: Other
Symptoms: Injection site erythema, Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

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: None
CDC Split Type:

Write-up: redness pain and swelling around Tdap site R deltoid


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