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This is VAERS ID 274463

Case Details

VAERS ID: 274463 (history)  
Form: Version 1.0  
Age: 21.0  
Gender: Female  
Location: Colorado  
Vaccinated:2007-01-26
Onset:2007-03-10
   Days after vaccination:43
Submitted: 2007-03-15
   Days after onset:4
Entered: 2007-03-21
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / 1 RA / IM

Administered by: Private       Purchased by: Private
Symptoms: Ear pain, Facial palsy, Influenza, Lacrimation increased, Otitis media acute, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad), Lacrimal disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (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: Levlen OCP
Current Illness:
Preexisting Conditions: Condyloma acuminatum
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received first dose of HPV on 1/26/07, then around 2/24/07 experienced flu symptoms which resolved. Then 3/10/07 experienced right sided facial swelling, right eye tearing, right ear pain. Seen by MD 3/12/07 and diagnosed with Acute Otitis Media and Bell''s Palsy. MRI scheduled but not completed yet. Question related Bell''s Palsy to vaccination? 05/29/07-records received-3/12/07-C/O 2 day right side facial weakness, right earache for 3 days and tender lump under right ear for 5-6 days. Numb around right side of lips. PE: right ear with erythema and dull typanic membrane and tender ear canal on exam. Neck tender 1 inch lymph node under right ear. Right facial muscles paralysis related to 7th cranial nerve. Able to close eyes completely though right eyelid weak. DX:Otitis media and Bell''s Palsy.


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