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This is VAERS ID 284446

Case Details

VAERS ID: 284446 (history)  
Age: 15.0  
Gender: Female  
Location: Oregon  
Vaccinated:2007-07-09
Onset:2007-07-09
   Days after vaccination:0
Submitted: 2007-07-12
   Days after onset:3
Entered: 2007-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 0442U / 1 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0389U / 0 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2232AA / 0 RA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C2689AA / 0 RA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0609U / 1 RA / SC

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

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Yaz, Claritin D
Current Illness:
Preexisting Conditions: Dysfunctional Uterine bleeding
Diagnostic Lab Data:
CDC Split Type:

Write-up: Back of R upper arm - redness area 8cm x 4cm with slight edema, pain at site - SQ injection of Varicella


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