National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 283792

Case Details

VAERS ID: 283792 (history)  
Form: Version 1.0  
Age: 30.0  
Gender: Female  
Location: Tennessee  
Vaccinated:2007-05-07
Onset:2007-05-07
   Days after vaccination:0
Submitted: 2007-06-14
   Days after onset:38
Entered: 2007-06-18
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0389U / 1 RA / IM

Administered by: Private       Purchased by: Private
Symptoms: Inappropriate schedule of drug administration, Nausea, Oedema peripheral, Pharyngeal oedema, Pyrexia, Rash, Swelling face
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal allergic conditions (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Medication errors (narrow), 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: NUVARING
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC Split Type: WAES0705USA01729

Write-up: Information has been received from a health professional concerning a 30 year old female with no pertinent medical history who on 07-MAY-2007 was vaccinated intramuscularly with Gardasil (lot #657736/0389U). Concomitant therapy included ethinyl estradiol (+) etonogestrel (NUVARING). On 07-MAY-2007, five hours after receiving the first dose of the vaccination, the patient experienced a feeling like her throat was swollen and nausea. On 08-MAY-2007 the patient experienced swelling of the face, swelling of both hands, tiny bumps on both hands and low grade fever of 100.9F. The patient was examined by a physician and prescribed oral diphenhydramine hydrochloride (Benadryl). At the time of the report the patient had not recovered. There were no laboratory or diagnostic tests performed. Additional information has been requested. 10/08/07 This is in follow-up to report(s) previously submitted on 6/14/2007. Information has been received from a health professional concerning a 30 year old female, with no pertinent medical history, who on 07-MAY-2007 at 2:00 pm was vaccinated in the right deltoid with a first dose of GARDASIL (lot # 657736/0389U). Concomitant therapy included NUVARING. On 07-MAY-2007 at 7:00 pm the patient experienced a feeling like her throat was swollen, nausea and swelling of both hands with tiny bumps. On 08-MAY-2007 the patient experienced swelling of the face and low grade fever of 100.9F. The patient was examined by a physician and prescribed oral BENADRYL. There were no laboratory or diagnostic tests performed. On 09-MAY-2007, the patient recovered from a feeling like her throat was swollen, nausea, swelling of the face, swelling of both hands, tiny bumps on both hands and low grade fever of 100.9F. Additional information is not expected.


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=283792


Copyright © 2017 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166