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This is VAERS ID 309086
VAERS ID: 309086 (history) Vaccinated: 2007-12-05 Age: 17.0 Onset: 2007-12-06, Days after vaccination: 1 Gender: Female Submitted: 2008-04-08, Days after onset: 123 Location: Illinois Entered: 2008-04-08
Life Threatening? No
Permanent Disability? No Recovered? Yes
ER or Doctor Visit? No Hospitalized? No Previous Vaccinations: Other Medications: Current Illness: denies Preexisting Conditions: none Diagnostic Lab Data: CDC Split Type:
Vaccination Manufacturer Lot Dose Route Site UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) UNKNOWN MANUFACTURER 15522U 1 IM LA
Administered by: Unknown Purchased by: Unknown Symptoms: Injection site erythema,
Injection site pain,
Injection site rash SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Left arm sore with a red bumpy rash that extended down the arm. Patient states that rash lasted for one month. Did not call our office to report adverse reaction. Immunization administered was Gardasil #2.
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