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This is VAERS ID 267995

Case Details

VAERS ID: 267995 (history)  
Form: Version 1.0  
Age: 17.0  
Gender: Female  
Location: Missouri  
Vaccinated:2006-11-20
Onset:2006-11-24
   Days after vaccination:4
Submitted: 2006-11-29
   Days after onset:5
Entered: 2006-11-30
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0688F / UNK LA / -

Administered by: Private       Purchased by: Private
Symptoms: Oedema peripheral, Swelling face
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), 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? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: 2nd dose Patient medicine on 11-20-06 and complain of swelling in lips, hands, and feet.


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