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This is VAERS ID 279547

Case Details

VAERS ID: 279547 (history)  
Age: 15.0  
Gender: Female  
Location: Unknown  
Vaccinated:2007-04-23
Onset:2007-04-23
   Days after vaccination:0
Submitted: 2007-05-14
   Days after onset:21
Entered: 2007-05-17
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / 0 UN / IM

Administered by: Other       Purchased by: Other
Symptoms: Injection site rash, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data:
CDC Split Type: WAES0704USA05394

Write-up: Information has been received from a licensed practical nurse concerning a 15 year old female who on 23-APR-2007 was vaccinated with the first dose of Gardasil in the left deltoid (lot# 654702/0010U). On 23-APR-2007 the patient experienced a rash and swelling from injection site to her elbow. At the time of the report the patient was recovering "on therapy" (not specified). Additional information has been requested. This is in follow-up to reports previously submitted on 5/14/2007. Initial and follow up information has been received from a licensed practial nurse concerning a 15 year old female stundent who on 23-APR-2007 was vaccinated IM with the first dose of GARDASIL (lot# 654702/0011U). Subsequently, immediately after the patient expeiienced rash, "jet red" swelling from injection site to her elbow. The patient was given BENADRYL 25mg tablet with good results. The swelling began to subside before the patient left the office. On 24-APR-2007, the patient recovered from the rash and "jet red" swelling from injection site to her elbow. The licensed practical nurse spoke to the mother and the patient the following day and there was no lasting effects. Additional information not expected.


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