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This is VAERS ID 283952

Case Details

VAERS ID: 283952 (history)  
Form: Version 1.0  
Age: 17.0  
Gender: Female  
Location: New York  
Vaccinated:2007-05-08
Onset:2007-05-08
   Days after vaccination:0
Submitted: 2007-06-14
   Days after onset:37
Entered: 2007-06-18
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0188U / 1 UN / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0169U / 2 UN / SC

Administered by: Private       Purchased by: Private
Symptoms: Erythema, Oedema peripheral, Pain in extremity
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0705USA02661

Write-up: Information has been received from a health professional concerning a female who on 08-MAY-2007 was vaccinated IM 0.5mL first dose with GARDASIL vaccine (yeast) (lot# 657006/0188U). Concomitant therapy included VARIVAX (MSD). Subsequently the patient experienced swollen arm and arm redness after the Gardasil injection. Subsequently, the patient recovered from swollen arm and arm redness. The patient sought unspecified medial attention. Additional information has been requested. This is in follow-up to report(s) previously submitted on 6/14/2007. Initial and follow up information has been received from s health professional concerning a female student who on 08-MAY-2007, in AM was vaccinated IM 0.5ml first dose with GARDASIL vaccine (yeast) (lot# 657006/0188U). Concomitant suspect therapy included one dose of VARIVAX (lot# 656078/0169U. Other concomitant therapy included MENACTRA vaccine . The patient experienced swollen arm and arm redness after the GARDASIL vaccine (yeast) injection. Subsequently , the patient recovered from swollen arm and arm redness. The patient sought unspecified medical attention. In follow up it was reported that on 08-MAY-2007, "patient said that her arns hurt" and then redness, swelling appaered on 09-MAY-2007 and redness was approximately quarter size. The patient recovered. Additional information is not expected.


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