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This is VAERS ID 188549

Case Details

VAERS ID: 188549 (history)  
Age: 1.1  
Gender: Female  
Location: North Carolina  
Vaccinated:2002-03-13
Onset:2002-03-20
   Days after vaccination:7
Submitted: 2002-03-22
   Days after onset:2
Entered: 2002-08-07
   Days after submission:137
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 5272A2 / 2 - / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR T1310 / 2 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0901L / 0 - / IM

Administered by: Private       Purchased by: Public
Symptoms: Abdominal pain upper, Anorexia, Dehydration, Ecchymosis, Erythema, Irritability, Malaise, Oedema peripheral, Pyrexia, Rash
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Bottle feeding; Gastrosephageal reflux disease
Preexisting Conditions: NONE
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Seven days after immunization onset of edema and erythema of hands and feet that also turned into some ecchymosis, accompanied by fever, anorexia, decreased fluid intake, malaise, slight dehydration, mild skin rash. 02/11/2010 Follow-up information from the reporting physician indicated that the 20 week old female who on 12-DEC-2007 was vaccinated PO with her second dose of GARDASIL (lot# 657663/1461U). There was no illness at the time of vaccination. Concomitant drug therapy included ZANTAC 2.0 ml PO BID. On 13-DEC-2007 the patient experienced irritability, increased flarulence and colicky symptoms characterized by stomach pain and cramping and was taking less formula. No medical attention was sought. No labs of x-rays were performed. On approximately 20-DEC-2007 within 1 week., the patietn recovered. Additional information has been requested.


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