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This is VAERS ID 313931

Case Details

VAERS ID: 313931 (history)  
Form: Version 1.0  
Age: 11.0  
Gender: Female  
Location: Maryland  
   Days after vaccination:0
Submitted: 2008-05-16
   Days after onset:232
Entered: 2008-05-23
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Private       Purchased by: Other
Symptoms: Pyrexia, Varicella post vaccine
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type: WAES0710USA01036

Write-up: Information has been received from a physician concerning an 11 year old female who on 27-SEP-2007 was vaccinated with a second 0.5mL dose of varicella virus vaccine live (Oka/Merck), (lot number not reported). On 27-SEP-2007, the patient developed a chicken pox rash that started on the patient''s scalp and then moved to her face, chest, arms and legs. The patient also developed a fever of 101 degrees F. No further information was available. The outcome was reported as recovered. Unspecified medical attention was sought. There was no product quality complaint. Follow up information has been received from a physician concerning an 11 year old female with no pre-existing allergies, or medical conditions who on 23-MAR-1998 was vaccinated subcutaneously into the right arm with a second dose of varicella virus vaccine live (Oka/Merck) (658293/1102U). Concomitant vaccine therapy administered within four weeks of varicella virus live included a first dose of Gardasil administered intramuscularly (IM) (Lot #656372/0243U), a sixth dose of Tripedia (Lot # C2770AA) administered IM into the left arm and a first dose of Menactra (Lot # N2339AA), administered IM. On 27-SEP-2007, at 10:00, the patient developed a rash on her scalp, and moved to her face, chest, arms and legs. The patient complained of severe itching. the patient was seen at the doctor''s office for a history of a fever up to 101 F. Observations at that time included a vesicular papular rash all over her face, arms, legs, chest and abdomen. The patient was advised to remain off from school at home, and isolated from siblings. No follow up was required unless problems should arise. No diagnostics labs studies obtained. There was no concomitant therapy. Medical attention was sought. There was not illness at the time of vaccination. There were no adverse events following previous vaccinations. At the time of reporting the patient''s status was unknown (previously reported as recovered). Additional information is not expected.

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