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This is VAERS ID 283984

Case Details

VAERS ID: 283984 (history)  
Form: Version 1.0  
Age: 16.0  
Gender: Female  
Location: New Jersey  
Vaccinated:2007-05-15
Onset:2007-05-15
   Days after vaccination:0
Submitted: 2007-06-14
   Days after onset:30
Entered: 2007-06-18
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0388U / 1 RA / IM

Administered by: Other       Purchased by: Other
Symptoms: Erythema, Oedema peripheral, Pain in extremity, Skin warm
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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PENTASA
Current Illness: Crohn''s disease
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0705USA03112

Write-up: Initial and follow-up information has been received from a health professional concerning a 16 year old female with Crohn''s disease who on 15-MAY-2007 was vaccinated in the right deltoid with Gardasil (lot # 657622/0388U). Concomitant therapy included PENTASA. The nurse reported that following vaccination, the patient developed a large, red, swollen, warm and painful area one inch below the injection site. The area was about 10 centimeters wide. The patient was given BENADRYL. The area had improved slightly since BENADRYL was started. At the time of the report, the patient had not recovered. The nurse also reported the experience of other patients with Gardasil (WAES #0705USA03739). Additional information has been requested.


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