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This is VAERS ID 283856

Case Details

VAERS ID: 283856 (history)  
Form: Version 1.0  
Age: 13.0  
Gender: Female  
Location: Maine  
Vaccinated:2007-06-11
Onset:2007-07-02
   Days after vaccination:21
Submitted: 2007-07-02
   Days after onset:0
Entered: 2007-07-05
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 0246U / 1 RA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0387U / 1 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2327AA / 1 RA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0362U / 2 LA / SC

Administered by: Private       Purchased by: Other
Symptoms: Pyrexia, Rash papular
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: papules on back noted on 07/02/07 low grade fever.


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