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This is VAERS ID 275584

Case Details

VAERS ID: 275584 (history)  
Form: Version 1.0  
Age: 16.0  
Gender: Female  
Location: Unknown  
Vaccinated:2007-03-01
Onset:2007-03-01
   Days after vaccination:0
Submitted: 2007-04-03
   Days after onset:32
Entered: 2007-04-04
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK UN / IM

Administered by: Other       Purchased by: Other
Symptoms: Chest discomfort, Dyspnoea, Erythema, Injection site pain, Injection site swelling, Oxygen supplementation
SMQs:, Anaphylactic reaction (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0703USA05676

Write-up: Information has been received from a registered nurse (a school nurse), via a company representative, concerning a 16 year old female patient, who in March 2007, was vaccinated with a dose, 0.5ml, IM, of Gardasil. The nurse reported that on the following day, the patient developed swelling and pain at the injection site, chest tightness, shortness of breath and facial redness, and was transported by ambulance to the emergency room. The nurse stated that treatment included oxygen, and epinephrine injection, and prednisone. Following treatment "the patient''s symptoms resolved and the patient completely recovered." The nurse considered the events to be life threatening and disabling. Additional information has been requested.


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