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This is VAERS ID 288955

Case Details

VAERS ID: 288955 (history)  
Form: Version 1.0  
Age: 14.0  
Sex: Female  
Location: New York  
Vaccinated:2007-08-23
Onset:2007-08-23
   Days after vaccination:0
Submitted: 2007-08-24
   Days after onset:1
Entered: 2007-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1061U / 1 LA / -

Administered by: Public       Purchased by: Unknown
Symptoms: Anaphylactic reaction, Face oedema, Swelling face, Urticaria generalised
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: no
Current Illness: no
Preexisting Conditions: no PMH: childhood asthma
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Anaphylactic/ type I/ reaction within 12 hours of vaccine Gardasil generalized urticaria, facial oedema. 10/16/07 Received ER medical records of 8/24/2007 which reveal patient experienced hives, swollen lips & face & itching all over. Tx w/epi, IV steroids, IV antihistamine. Improved & d/c to home FINAL DX: angioedema.


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