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This is VAERS ID 284746

Case Details

VAERS ID: 284746 (history)  
Form: Version 1.0  
Age: 15.0  
Gender: Female  
Location: Virginia  
Vaccinated:2007-06-07
Onset:2007-06-07
   Days after vaccination:0
Submitted: 2007-07-16
   Days after onset:39
Entered: 2007-07-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0171U / 2 LA / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Erythema, Mobility decreased, Nodule, Swelling, Tenderness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Parkinson-like events (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? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: NON
CDC Split Type:

Write-up: RECEIVED GARDASIL #2 6/7/07. SUBSEQUENTLY ARM BECAME MARKEDLY SWOLLEN, TENDER, AND ERYTHEMATUS. HAD DECREASED R.O.M. SAW DR. WHO PLACED PATIENT ON KEFLEX FOR 10 DAYS. ON 7/2/07, ARM STILL TENDER WITH 3CM ERYTHEMATUS NODULEAR TENDER TO TOUCH.


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