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This is VAERS ID 274705

Case Details

VAERS ID: 274705 (history)  
Form: Version 1.0  
Age: 15.0  
Gender: Female  
Location: Kentucky  
Vaccinated:2007-02-16
Onset:2007-02-16
   Days after vaccination:0
Submitted: 2010-06-08
   Days after onset:1207
Entered: 2007-03-16
   Days after submission:1180
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 1280F / 1 UN / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0167U / 2 UN / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Erythema, Injection site erythema, Oedema peripheral
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (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: Unknown
Current Illness: Drug hypersensitivity; Sulfonamide allergy
Preexisting Conditions: Immunization
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0702USA04332

Write-up: Information has been received from a health professional ("nurse"), via a company representative concerning a 15 year old female who on approximately 14 Feb 2007 ("sometime last week") was vaccinated IM with a second dose of Gardasil vaccine (yeast) (the patient''s first vaccination date was not reported). Concomitant suspect vaccinations included a dose of Varicella and hepatitis A vaccine (inactive). On approximately 14 Feb 2006 ("sometime last week"), the instant after getting the vaccinations, the patient developed a "swallowed" red arm 8-9cm long and 6 cm wide. At the time of the report, it was unknown if the patient had recovered. The patient sought unspecified medical attention. Additional information has been requested. This is in follow-up to report (s) previously submitted on 3/14/2007. Information has been received from a health professional ("nurse"), via a company representative and a physician concerning a 15 year old female (weight 124.25%, height 66.5%) with codeine and sulfa allergies who on 16-FEB-2007 was vaccinated IM in the left arm with a second dose of GARDASIL (lot #656049/0187U) (the patient''s first vaccination date was not reported). Concomitant suspect vaccinations on 16-FEB-2007 included the second dose of VARIVAX (lot # 654757/1257F), SC in the left arm and the first dose of VAQTA (lot #656017/1280F), IM in the right arm. Other concomitant medication was not reported. On 16-FEB-2006, the instant after getting the vaccinations, the patient developed a "swallowed" red arm 8-9 cm long and 6 cm wide (also reported as redness at the sie of the injection). The patient sought unspecified medical attention and was treated with ZYRTEC. On 16-FEB-2007, the patient recovered from the event. Additional information is not expected. This is in follow-up to report (s) previously submitted on 3/14/2007; 7/6/2007. Information has been received from a health professional ("nurse"), via a company representative and a physician concerning a 15 year old female with codeine and sulfa allergies who on 16-FEB-2007 was vaccinated IM in the left arm with a second dose of GARDASIL (lot #656049/0187U) (the patient''s first vaccination date was not reported). Concomitant suspect vaccination on 16-FEB-2007 included the second dose of VARIVAX (lot # 654752/1257F), SC in the left arm. Other concomitant medication included the first dose of VAQTA (lot #656017/1280F), IM in the right arm. On 16-FEB-2006, the instant after getting the vaccinations, the patient developed a "swallowed" red arm 8-9 cm long and 6 cm wide (also reported as redness at the site of the injection). The patient sought unspecified medical attention and was treated with ZYRTEC. On 16-FEB-2007, the patient recovered from the event. Additional information is not expected.


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