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This is VAERS ID 279057

Case Details

VAERS ID: 279057 (history)  
Age: 15.0  
Gender: Female  
Location: California  
Vaccinated:2007-03-20
Onset:2007-03-20
   Days after vaccination:0
Submitted: 2007-05-14
   Days after onset:55
Entered: 2007-05-17
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR - / 0 UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unk
Diagnostic Lab Data: none
CDC Split Type: WAES0704USA00665

Write-up: Information has been received from a physician concerning a 15 year old female who on approximately 20-MAR-2007, "a couple weeks ago", was vaccinated with a first dose of Gardasil. Subsequently the patient developed swelling. The patient sought unspecified medical attention. At the time of this report, the patient''s outcome was unknown. No product quality complaint was involved. Additional information has been requested.


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