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This is VAERS ID 269198

Case Details

VAERS ID: 269198 (history)  
Form: Version 1.0  
Age: 11.0  
Gender: Female  
Location: New York  
Vaccinated:2006-11-01
Onset:2006-11-09
   Days after vaccination:8
Submitted: 2006-12-14
   Days after onset:35
Entered: 2006-12-18
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0954F / 1 - / IM

Administered by: Other       Purchased by: Other
Symptoms: Drug hypersensitivity, Erythema, Injection site cellulitis, Oedema peripheral, Pain in extremity, Skin warm, Tenderness
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), 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: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC Split Type: WAES0611USA04358

Write-up: Information has been received from a physician concerning a 11 year old female who on 01-Nov-2006 was vaccinated with a 0.5 ml first dose of Gardasil (yeast) (lot #653938/0954F). On 09 Nov 2006 the patient developed cellulitis in the arm where vaccine was administered. Unspecified medical attention was sought. At the time of the report, the patient was recovering from the cellulitis. Additional information has been requested. This is in follow-up to report9s0 previously submitted on 12/14/2006. Entitle and follow-up information has been received from a physician concerning a 11 year old female student with a cephalosporin allergy who on 01-NOV-2006 was vaccinated with a 0.5 ml first dose of GRDASIL (lot # 653938/0954F). On 09-NOV-2006 the patient developed cellulites in the arm where vaccine was administrated. The patient''s arm was red, hot, swollen, painful and tender. The patient sought medical attention. A complete blood cell count and x-ray were performed (results in reported). It was reported that the patient had an allergic reaction to cephalexin “once started." Subsequently, the patient recovered from cellulites. Follow-up information reported the physician considered cellulites to be disabling event. Additional information has been requested.


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