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This is VAERS ID 300367

Case Details

VAERS ID: 300367 (history)  
Form: Version 1.0  
Age: 16.0  
Gender: Female  
Location: Foreign  
   Days after vaccination:1
Submitted: 2007-12-18
   Days after onset:56
Entered: 2007-12-19
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Unknown       Purchased by: Unknown
Symptoms: Cervical root pain, Injected limb mobility decreased, Injection site oedema, Injection site pain, Injection site swelling
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? Yes
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ADEPAL
Current Illness:
Preexisting Conditions: Psoriasis; Anxiety
Diagnostic Lab Data: None
CDC Split Type: WAES0712USA03919

Write-up: Information has been received from a health professional concerning a 16 year old female with a history of psoriasis and anxiety who on 22-OCT-2007 was vaccinated with a first dose of Gardasil (lot# unknown) IM in the left deltoid. Concomitant therapy included ADEPAL. On 23-OCT-2007, the day after vaccination the patient developed oedema and pain at the site of injection. Subsequently oedema extended to the whole left arm and hand and was associated with complete functional impairment. The event was complicated by cervicobrachial neuralgia that was induced, according to the physician, by the vicious position caused by pain. The patient was treated with immobilisation of the left arm. The patient recovered from oedema and injection site pain after 15 days. At the time of reporting, the patient had not recovered from cervicobrachial neuralgia. The reporter considered the event as serious. Additional information is not expected. Other business partners included are: E2007-09130.

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