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This is VAERS ID 279663

(NOTE: This result is from the 4/7/2010 version of the VAERS database)

Case Details

VAERS ID: 279663 (history)  
Form: Version .0  
Age: 25.0  
Gender: Female  
Location: Missouri  
Submitted: 2007-05-14
Entered: 2007-05-17
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Erythema, Injection site erythema, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

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: None
Current Illness: Allergic reaction to antibiotics; Penicillin allergy
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type: WAES0705USA00119

Write-up: Initial and follow-up information has been received from a physician concerning a 26 year old female with no known medical history and allergies to penicillin, amoxicillin and Biaxin who on 27-DEC-2006 was vaccinated intramuscularly with a second 0.5 mL dose of Gardasil (Lot #653937/0637F). There was no concomitant medication. Subsequently, on an unspecified date, the patient developed a quarter size area of redness at the injection site. No laboratory diagnostic tests were performed. Approximately one month after the injection was given, the patient recovered. It was also noted that on 30-Apr-2007, the patient was vaccinated with a dose of GARDASIL (Lot # 657622/0386U). On an unspecified date, the patient developed redness, swelling. On an unknown date, the patient recovered.No product quality complaint was involved. Additional information has been requested. This is in follow-up to report (s) previously submitted on 5/14/2007. Additional information is not expected.

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