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This is VAERS ID 279454

Case Details

VAERS ID: 279454 (history)  
Form: Version 1.0  
Age: 13.0  
Gender: Female  
Location: Unknown  
   Days after vaccination:0
Submitted: 2007-05-23
   Days after onset:58
Entered: 2007-05-24
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Unknown       Purchased by: Unknown
Symptoms: Chest pain, Dyspnoea, Nausea, Oedema peripheral, Pain in extremity, Swelling face, Vomiting
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (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? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data:
CDC Split Type: WAES0705USA03775

Write-up: Information has been received from a nurse practitioner concerning a 13 year old female who on 26-MAR-2007 was vaccinated with Gardasil. On 26-MAR-2007 the patient developed swelling of the arm, arm and chest pain, nausea, vomiting, facial swelling and difficulty breathing. The patient went to the emergency room and was treated with Phenergan. Subsequently, the patient recovered. The nurse practitioner reported that she never saw this type of reaction before and that the patient never reacted to any other vaccine. The reporter felt that the swelling of the arm, arm and chest pain, nausea, vomiting, facial swelling and difficulty breathing were other important medial events. Additional information has been requested.

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