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This is VAERS ID 290916

Case Details

VAERS ID:290916 (history)  Vaccinated:2007-09-17
Age:17.0  Onset:2007-09-17, Days after vaccination: 0
Gender:Female  Submitted:2007-09-19, Days after onset: 2
Location:Massachusetts  Entered:2007-09-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Allergic rhinitis, Acne
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC2758AA0IMLA
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER1061W0IMRA
Administered by: Public     Purchased by: Public
Symptoms: Chest pain, Dyspnoea, Pharyngeal oedema
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: Patient experienced throat swelling, difficulty breathing and chest pain on inspiration just after leaving the office where she had received Gardasil and Adacel. Symptoms gradually resolved over 48 hours. She did not pursue any medical treatment until 48hrs later and did not take any medications.

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