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This is VAERS ID 274594

Case Details

VAERS ID: 274594 (history)  
Form: Version 1.0  
Age: 12.0  
Gender: Female  
Location: Unknown  
   Days after vaccination:0
Submitted: 2007-03-14
   Days after onset:25
Entered: 2007-03-16
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 2 UN / -

Administered by: Other       Purchased by: Other
Symptoms: Headache, Inappropriate schedule of drug administration, Lip swelling, Neck pain, Pharyngolaryngeal pain
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Arthritis (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: Allergic reaction to antibiotics
Preexisting Conditions: Birth defects; Surgery
Diagnostic Lab Data: NONE
CDC Split Type: WAES0702USA04212

Write-up: Information has been received from a consumer concerning her 12 year old daughter with a history of surgery for birth defects and allergic to erythromycin who on 15-JAN-2007 and 16-FEB-2007 was vaccinated with a first and second dose of Gardasil, respectively. There was no concomitant medication. On 22-FEB-2007 ''last night", the consumer''s daughter experienced headache, sore throat, neck pain and her lips were swollen. No medical attention was sought. No laboratory studies were performed. At the time of this report, the consumer''s daughter had not recovered. It was also reported that she tolerated her first of the vaccine with any events. The consumer plans on having her daughter receive the third dose of the vaccine. No product quality complaint was involved. Additional information is not expected.

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