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This is VAERS ID 276124

Case Details

VAERS ID: 276124 (history)  
Form: Version 1.0  
Age: 15.0  
Gender: Female  
Location: Unknown  
   Days after vaccination:0
Submitted: 2007-04-06
   Days after onset:41
Entered: 2007-04-09
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 - / IM

Administered by: Other       Purchased by: Other
Symptoms: Oedema peripheral, Urticaria
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (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? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type: WAES0703USA00421

Write-up: Information has been received from a physician assistant concerning a 15 year old "healthy individual" female who on approximately 23-FEB-2007, was vaccinated with Gardasil first dose. On approximately 23-FEB-2007 (also reported as about a week after Gardasil was administered, the patient experienced swelling and hives in her extremities area. The reporting physician assistant does not treat this patient and did not want to be contacted. The treating physician works in the same office as the reporter but also did not want to contacted as the physician did not feel the events were related. No lab or diagnostic tests were performed. Unspecified medical attention was sought. As of 02-MAR-2007, the patient''s swelling and hives in her extremities persisted. No further information is available.

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