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This is VAERS ID 271108

Case Details

VAERS ID: 271108 (history)  
Form: Version 1.0  
Age: 24.0  
Gender: Female  
Location: Kentucky  
Vaccinated:2006-12-08
Onset:2006-12-09
   Days after vaccination:1
Submitted: 2007-01-16
   Days after onset:38
Entered: 2007-01-22
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / -
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0868F / UNK - / IM

Administered by: Other       Purchased by: Other
Symptoms: Breast swelling
SMQs:, Angioedema (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: hormonal contraceptives
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type: WAES0612USA02283

Write-up: Information has been received from a physician concerning a 24 year old female with no pertinent medical history or drug reactions/allergies, who on 08-Dec-2006 was vaccinated intramuscularly with Gardasil vaccine (yeast) (0.5 ml) (lot#653736/0868F). Concomitant vaccination given on an unspecified date included influenza virus vaccine (unspecified). Other concomitant medication included hormonal contraceptives (unspecified).On 09-Dec-2006, one day after receiving the Gardasil vaccine (yeast), the patient experienced breast swelling. It was reported that there was no significant pain, however the patient could not lie on her breast. Unspecified medical attention was sought. At the time of this report, the patient was recovering. Additional information has been requested.


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