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This is VAERS ID 284513

Case Details

VAERS ID: 284513 (history)  
Age: 17.0  
Gender: Female  
Location: Massachusetts  
Vaccinated:2007-05-25
Onset:2007-05-25
   Days after vaccination:0
Submitted: 2007-06-14
   Days after onset:20
Entered: 2007-06-18
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0387U / 1 LA / IM

Administered by: Private       Purchased by: Private
Symptoms: Injection site induration, Injection site mass, Injection site pain, Oedema peripheral, Pain, Rash, Similar reaction on previous exposure to drug
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0705USA05439

Write-up: Information has been received from a health professional concerning her 17 year old daughter who on 25-MAY-2007 was vaccinated IM in deltoid with a second dose of Gardasil. On 25-MAY-2007 the patient experienced pain next to the injection site after vaccination and her arm started to swell. Two days later bumps appeared on the same arm. She was given over the counter ibuprofen (Motrin) for pain. The reporter reported that patient experienced mild pain at the injection site after getting her first dose of Gardasil. The patient has not recovered. Additional information has been requested. 10/08/07 This is in follow-up to report(s) previously submitted on 6/14/2007. Initial and follow up information has been received from a health professional concerning her 17 year old daughter who on 25-MAY-2007 at 03:30 PM was vaccinated IM in left deltoid with a second dose of GARDASIL lot #657621/0387U. On 25-MAY-2007 the patient experienced pain next to the injection site after vaccination and her arm started to swell. Two days later bumps appeared on the same arm. She was given over the counter MOTRIN for pain. The reporter reported that patient experienced mild pain at the injection site after getting her first dose of GARDASIL. In follow up information it was reported that on 25-MAY-2007, at 06:30 PM patient had "hard painful lump adjacent to injection site with multiple raised smaller non painful bumps down and around the same arm". It was reported that on 01-JUN-2007 patient recovered. Additional information is not expected.


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