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This is VAERS ID 282596

Case Details

VAERS ID: 282596 (history)  
Form: Version 1.0  
Age: 14.0  
Gender: Female  
Location: Minnesota  
Vaccinated:2007-06-07
Onset:2007-06-19
   Days after vaccination:12
Submitted: 2007-06-21
   Days after onset:2
Entered: 2007-06-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0389U / 1 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2323AA / 1 LA / IM

Administered by: Private       Purchased by: Other
Symptoms: Erythema, Joint swelling, Oedema peripheral, Pain, Tonsillitis, Urticaria
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Agranulocytosis (broad), Angioedema (narrow), Oropharyngeal infections (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad), 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? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none noted
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 6/19/07 onset of urticaria , Left index finger swelling; 6/20/07 generalized urticaria, joint swelling of wrists/index finger, pain of coccyx, pain bilateral forearms with redness slight tonsil/ 6/21/07 swelling severe of hands, wrists, knees, increased urticara.


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