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This is VAERS ID 283743

Case Details

VAERS ID: 283743 (history)  
Form: Version 1.0  
Age:   
Gender: Female  
Location: Unknown  
Vaccinated:2007-05-01
Onset:2007-05-02
   Days after vaccination:1
Submitted: 2007-06-14
   Days after onset:43
Entered: 2007-06-18
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK UN / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Erythema, Rash, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: None
CDC Split Type: WAWES0705USA00541

Write-up: Information has been received from a registered nurse concerning a female who on 01-MAY-2007 was vaccinated with a dose of Gardasil (lot # not provided). It was unknown if the dose was a first dose or if a previous dose had been given. The morning after vaccination, on 02-MAY-2007, the patient woke up with a swollen face and red spots on her legs. The patient sought unspecified medical attention. The Patient''s swollen face and red spots on her legs persisted. Additional information has been requested.


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