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This is VAERS ID 272342

Case Details

VAERS ID: 272342 (history)  
Form: Version 1.0  
Age: 22.0  
Gender: Female  
Location: Washington  
   Days after vaccination:0
Submitted: 2007-02-14
   Days after onset:95
Entered: 2007-02-15
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 - / -

Administered by: Other       Purchased by: Other
Symptoms: Contusion, Injection site swelling, Tenderness
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

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: UNK
Current Illness:
Preexisting Conditions: hypersensitivity
Diagnostic Lab Data: UNK
CDC Split Type: WAES0701USA02181

Write-up: Information has been received from an R.N. concerning a 22 year old female patient with an allergy to codeine who on 11-NOV-2006 was vaccinated with her first dose of HPV rL1 6 11 16 18 VLP vaccine (yeast); and according to the nurse, developed severe swelling on the injection site arm after the first dose. The patient received the first vaccination at another office and no information was available on where the first vaccination was administered or the physician involved in the first vaccination. On 16-JAN-2007 the patient was seen in the office. She was breast feeding, and was reported to have been breast feeding when the first vaccination was administered. The patient reported that she had developed an egg shaped swelling at the injection site on the left upper arm that lasted for more than one week after the first vaccination. No timeline on the development of the swelling in relation to the vaccination was available. The arm was still bruised and tender 2 months after the first vaccination. The second dose of HPV rL1 6 11 16 18 VLP vaccine (yeast) has not been administered. At the time of the report, the patient was recovering. Additional information has been requested.

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