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This is VAERS ID 284013

Case Details

VAERS ID: 284013 (history)  
Age: 14.0  
Gender: Female  
Location: New York  
Vaccinated:2007-06-25
Onset:2007-06-28
   Days after vaccination:3
Submitted: 2007-07-06
   Days after onset:8
Entered: 2007-07-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0524U / 0 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0644U / 1 RA / SC

Administered by: Private       Purchased by: Private
Symptoms: Erythema, Tenderness
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), 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: None
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Red, hard, tender over right tricep --$g 4-5cm diameter. Reassurance ice pack/ Motrin.


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