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This is VAERS ID 276126

Case Details

VAERS ID: 276126 (history)  
Form: Version 1.0  
Age: 23.0  
Sex: Female  
Location: Texas  
Submitted: 2007-04-06
Entered: 2007-04-09
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 - / -

Administered by: Other       Purchased by: Other
Symptoms: Nodule on extremity, Oedema peripheral, Pruritus
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (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? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unk
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: Unk
CDC Split Type: WAES0703USA00440

Write-up: Information has been received from a physician concerning a 23 year old female who in December 2006, was vaccinated into the left arm with a 0.5mL first dose of Gardasil. Subsequently, on an unspecified date, the patient developed a swollen arm (reported via company representative). The physician also reported that the patient developed a "nodule on the left arm under the skin, "a pouch, which intermittently becomes itchy." (date not reported). At the time of the report, the patient had not recovered. The patient sough unspecified medical attention. Additional information is not available.

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