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This is VAERS ID 284666

Case Details

VAERS ID: 284666 (history)  
Age: 11.0  
Gender: Female  
Location: Georgia  
Vaccinated:2007-07-10
Onset:2007-07-11
   Days after vaccination:1
Submitted: 2007-07-11
   Days after onset:0
Entered: 2007-07-13
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB149AA / 0 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0389U / 0 RA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C2572AA / 0 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0601U / 1 RA / SC

Administered by: Public       Purchased by: Unknown
Symptoms: Erythema, Oedema peripheral, Skin warm
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: No fever, redness, slight swelling, RA, warm to touch, slightly firm advised to go to ER. Treatment per ER physician Claritin, Benadryl, Ibuprofen 200mg.


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