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This is VAERS ID 276158

Case Details

VAERS ID: 276158 (history)  
Form: Version 1.0  
Age: 16.0  
Gender: Female  
Location: Unknown  
   Days after vaccination:0
Submitted: 2007-04-06
   Days after onset:38
Entered: 2007-04-09
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Private       Purchased by: Other
Symptoms: Dizziness, Erythema, Headache, Injection site erythema, Injection site pain, Injection site swelling, Oedema peripheral
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), 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? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Drug hypersensitivity
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type: WAES0703USA00994

Write-up: Information has been received from a registered nurse concerning a 16 year old female with an allergy to amoxicillin (+) clavulanate potassium (Augmentin) who on 26-FEB-2007 was vaccinated with the first IM dose of 0.5 ml of Gardasil (lot # 655849/0263). There was no concomitant medication. Later in the day, on 26-FEB-2007 the patient experienced soreness at the injection site. On 27-FEB-2007 the patient developed arm redness and swelling from injection site to fingertips. There was no itching. The patient also experienced dizziness and headache throughout the day (frequency and duration unknown). The patient took ibuprofen on 28-FEB-2007 for the swelling. The swelling and redness subsided the morning of 01-MAR-2007. The patient was still reporting pain at the injection site and no swelling or redness on 05-MAR-2007. The patient was recovering from dizziness and headache. The patient had not been examined at the office since the vaccination. No lab testing was performed. Additional information has been requested.

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