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This is VAERS ID 284330

Case Details

VAERS ID: 284330 (history)  
Age: 14.0  
Gender: Female  
Location: Ohio  
Vaccinated:2006-12-29
Onset:2006-12-29
   Days after vaccination:0
Submitted: 2007-06-30
   Days after onset:182
Entered: 2007-07-11
   Days after submission:11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U2312AA / - RA / IM
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 1008F / - LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1425F / - LA / IM

Administered by: Private       Purchased by: Private
Symptoms: Injection site bruising, Injection site swelling, Pyrexia
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Fever - 12/29/06, bruising at the injection site 12/30/06, swelling approximately golf size at the injection site - 12/30/06.


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