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This is VAERS ID 309086

(NOTE: This result is from the 4/14/2017 version of the VAERS database)

Case Details

VAERS ID: 309086 (history)  
Form: Version .0  
Age: 17.0  
Gender: Female  
Location: Illinois  
Vaccinated:2007-12-05
Onset:2007-12-06
   Days after vaccination:1
Submitted: 2008-04-08
   Days after onset:123
Entered: 2008-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER 15522U / 1 LA / IM

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)

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

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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Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20170414&IDNUMBER=309086


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