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This is VAERS ID 348025

Case Details

VAERS ID: 348025 (history)  
Form: Version 1.0  
Age: 9.0  
Gender: Female  
Location: Pennsylvania  
   Days after vaccination:1
Submitted: 2009-05-15
   Days after onset:400
Entered: 2009-05-21
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type: WAES0804USA03185

Write-up: Information has been received from a registered nurse concerning a 9 year old patient with a history of premature puberty and asthma and a drug reaction/allergies that included an unknown reaction to flu vaccine, who on 09-APR-2008 was vaccinated IM with a dose of VARIVAX (Merck) (lot number: 659610/1654U). Suspect therapy included GARDASIL. On 10-APR-2008 the patient developed local swelling, redness and a lump under the skin at the injection site. Recommended treatment was ice and MOTRIN. There were no lab diagnostic studies performed. Unspecified medical attention was sought, via phone call to the office. The outcome was reported as recovering. There was no product quality complaint. Follow-up information from the reporting medical assistant (also reported as registered nurse) indicated that the 9 year old female who on 09-APR-2008 at 12:00 was vaccinated IM with her second dose of VARIVAX (Merck) (lot# 659610/1654U). After vaccination the patient developed redness and swelling. Additional information has been requested.

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