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This is VAERS ID 278653

Case Details

VAERS ID: 278653 (history)  
Form: Version 1.0  
Age: 12.0  
Gender: Female  
Location: Illinois  
Vaccinated:2007-04-23
Onset:2007-05-13
   Days after vaccination:20
Submitted: 2007-05-15
   Days after onset:2
Entered: 2007-05-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1447F / 2 LA / IM

Administered by: Public       Purchased by: Public
Symptoms: Erythema, Oedema peripheral, Pain, Skin warm
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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 5/15/2007 Mother reports that Shantel''s arm is red, swollen and warm to touch. Denies any fever. States school nurse put cool compress on it 5/14/2007 and Shantel complained that it hurt worse.Instr to try a warm compress and take tylnol or motrin for the pain and swelling. Also instr to f/u with MD. Question if it may have been a bite of some sort. Mother unsure.


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