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This is VAERS ID 284478

Case Details

VAERS ID: 284478 (history)  
Form: Version 1.0  
Age: 22.0  
Gender: Female  
Location: Unknown  
   Days after vaccination:0
Submitted: 2007-06-14
   Days after onset:62
Entered: 2007-06-18
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Private       Purchased by: Private
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth, Sleep disorder
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? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown; JASMIN 28; PROZAC
Current Illness: Drug hypersensitivity
Preexisting Conditions: Headache; Knee operation
Diagnostic Lab Data: None
CDC Split Type: WAES0705USA04419

Write-up: This is in follow-up to report(s) previously submitted on 6/14/2007. Information has been received from a registered nurse concerning a 22 year old female with no illness at the time of being vaccinated and a history of an allergy to acetaminophen (+) hydrocodone bitartrate (VICODIN), headaches, and knee surgery who on 13-APR-2007 was vaccinated with a first dose of Gardasil (lot #657617/0384U) in the left arm in the morning. Concomitant therapy included JASMIN 28, and PROZAC. On 13-APR-2007, the patient experienced general pain at the injection site since the injection. On 24-APR-2007, in the PM, the injection site became red and hot, "bubbled up". The throbbing was waking her up. The patient visited the office on 27-APR-2007. On 27-APR-2007, there was no redness or lump or swelling noted; events resolved. No further information is available. Additional information was received from a nurse practitioner. After the first dose of vaccine, the patient developed swelling of her left arm at the injection site "to the site of a softball" as per the patient. Medical attention was sought. The nurse practitioner saw the patient on 27-APR-2007 and her assessment was unremarkable. On 15-JUN-2007, the patient returned to the office for her second dose of GARDASIL (lot # 65786/0523U) 0.5 ml IM in the right arm and was observed after the injection. The patient began to complain of tingling in her right hand, and stiffness and tenderness at the right shoulder. At the time of reporting, the patient was recovering. No additional information was available at the time of reporting.

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