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This is VAERS ID 284476

Case Details

VAERS ID: 284476 (history)  
Form: Version 1.0  
Age: 10.0  
Gender: Female  
Location: Minnesota  
Vaccinated:2007-05-22
Onset:2007-05-22
   Days after vaccination:0
Submitted: 2007-06-14
   Days after onset:23
Entered: 2007-06-18
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Injection site erythema, Injection site pruritus, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

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:
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0705USA04409

Write-up: Information has been received from a physician concerning a 10 year old female who on 22-MAY-2007 was vaccinated IM with 0.5 ml of the first dose of Gardasil. Concomitant therapy included Varivax (MSD) and hepatitis A virus vaccine (unspecified). On 22-MAY-2007 the patient experienced injection site redness, swelling and itching. As of 23-MAY-2007, the patient had not recovered from her experience. Medical attention was sought. Additional information has been requested.


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