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This is VAERS ID 263895

Case Details

VAERS ID: 263895 (history)  
Form: Version 1.0  
Age: 18.0  
Gender: Female  
Location: Maine  
Vaccinated:2006-09-25
Onset:2006-09-25
   Days after vaccination:0
Submitted: 2006-09-29
   Days after onset:4
Entered: 2006-10-03
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0688F / UNK LA / IM

Administered by: Other       Purchased by: Other
Symptoms: Dyspnoea, Oedema peripheral, Swelling face
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), 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: Wellbutrin XL; lithium carbonate; Risperdal
Current Illness: Asthma; Polycystic ovaries; Cold
Preexisting Conditions: Asthma; Polycystic ovaries; cold
Allergies:
Diagnostic Lab Data: None
CDC Split Type: WAES0609USA06568

Write-up: Initial and follow up information has been received from a registered nurse concerning an 18 year old female with asthma, polycystic ovaries and no known allergies or adverse drug reactions reported. On 25-SEP-2006, the patient was vaccinated intramuscularly with a 0.5 ml dose of HPV rLi 6 11 16 18 VLP vaccine (yeast) (lot#653735/0688F). Concomitant therapy included bupropion HCL (WELLBUTRIN XL), lithium carbonate and risperidone (RISPERDAL). That evening, on 25-SEP-2006, the patient developed left arm swelling and difficulty breathing. It was reported that the difficulty breathing could be due to the patient having a cold and being an asthmatic. On 26-SEP-2006 the patient developed facial swelling. The patient sought unspecified medical attention. It was reported that a nurse practitioner and physician were doing an assessment and consultation. On an unspecified date, the patient had the assessment and consultation and her symptoms were not considered to be serious. At the time of this report, the patient was recovering from th events. The reporter considered the events to be serious as other important medical events (date unknown). Additional information is not expected.


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