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This is VAERS ID 283541

Case Details

VAERS ID: 283541 (history)  
Form: Version 1.0  
Age: 12.0  
Gender: Female  
Location: Colorado  
Vaccinated:2007-06-14
Onset:2007-06-15
   Days after vaccination:1
Submitted: 2007-06-15
   Days after onset:0
Entered: 2007-07-02
   Days after submission:17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 1 RA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C2631AA / 1 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0534U / 2 LA / SC

Administered by: Public       Purchased by: Unknown
Symptoms: Injection site erythema
SMQs:, Extravasation events (injections, infusions and implants) (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Advair for asthma, Albuterol meds for allergies
Current Illness:
Preexisting Conditions: Molds, pollens, dust, peanuts ?cats/dogs.
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Has a raised, red area on fatty area of Lt arm. Measures approximately 2" wide x 1 1/2" high - Probably where Varicella given - also outside with mosquito''s?


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