The following is all the information available on report# VAERS_ID: 738302
Vaccine(s) were received on 04/13/2016
Vaccine(s) were received in the state: AZ
At the time of vaccination, patient was : 11 of age
Patient sex : M
Date reaction was reported: 02/03/2018
Reaction was life threatening?: N
Patient eventually recovered from reaction ?: Y
Patient eventually died?: N
Injected limb mobility decreased
Peripheral swelling
Skin warm
Swelling
Vaccine(s) were received in the state: AZ
At the time of vaccination, patient was : 11 of age
Patient sex : M
Date reaction was reported: 02/03/2018
Reaction was life threatening?: N
Patient eventually recovered from reaction ?: Y
Patient eventually died?: N
The following Lab Data for this case is available: None
The following Data for this patients ALLERGIES is available: [ ]
Description of adverse reaction: Had redness, swelling and increased warmth within 2-3 hrs after shot and had difficulty moving and lifting left arm over next 2-3 days. Right arm has some redness and swelling after injection but resolved. Guardian just told us of event on 1-30-19 prior to giving booster vaccines.
Vaccine(s) associated with report# 738302
| Type | Name | Manufacturer | Vaccine LOT # | Dose Series | ROUTE | Site |
|---|---|---|---|---|---|---|
| HPV4 | HPV (GARDASIL) | MERCK & CO. INC. | L048237 | 1 | IM | UN |
| MNQ | MENINGOCOCCAL CONJUGATE (MENACTRA) | SANOFI PASTEUR | U5186AA | 1 | IM | UN |
| TDAP | TDAP (ADACEL) | SANOFI PASTEUR | U526AAA | 1 | IM | UN |
Symptoms(s) associated with report# 738302
ErythemaInjected limb mobility decreased
Peripheral swelling
Skin warm
Swelling