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This is VAERS ID 267822

Case Details

VAERS ID: 267822 (history)  
Age: 15.0  
Gender: Female  
Location: Illinois  
Vaccinated:2006-11-14
Onset:2006-11-15
   Days after vaccination:1
Submitted: 2006-11-17
   Days after onset:2
Entered: 2006-11-27
   Days after submission:10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0954F / 1 RA / IM

Administered by: Private       Purchased by: Private
Symptoms: Erythema, Malaise, Periorbital oedema, Pruritus, Swelling face, Throat tightness
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Benzaclin, Minocin, Orthotricyclen, Prozac
Current Illness: NONE
Preexisting Conditions: Acne, Anxiety, depression, TSS (11/05)
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt suddenly did not feel well at 9:30 am 11/15 went to bathroom, noticed face very red, followed by intense itching - presented to clinic 1 hr after sxs started, developed swollen lips, edema around eyes and throat constriction. Epi 0.05 ml SQ immediately. 3 min later, pt improved.


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