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This is VAERS ID 388326

Case Details

VAERS ID:388326 (history)  Vaccinated:0000-00-00
Age:15.0  Onset:2009-01-15
Gender:Female  Submitted:2010-05-14, Days after onset: 483
Location:Pennsylvania  Entered:2010-05-18, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Penicillin allergy; Sulfonamide allergy; Hypersensitivity
Preexisting Conditions: Vaccination adverse reaction
Diagnostic Lab Data: complete blood cell, normal; erythrocyte, $g31
CDC Split Type: WAES0904USA01138
Administered by: Private     Purchased by: Other
Symptoms: Allergy to vaccine, Full blood count normal, Injection site erythema, Injection site induration, Oedema peripheral, Red blood cell sedimentation rate increased
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Information has been received from a physician concerning a female patient with penicillin allergy, sulfonamide allergy and cephalosporin allergy who on an unknown date was vaccinated with VARIVAX (Merck). Subsequently the patient experienced allergy to VARIVAX. The outcome of the adverse event was not reported. The patient experienced swelling of upper arm. Significant elevated levels of IgE and erythematous induration at site of injection while on therapy with GARDASIL, (WAES# 0902USA01435). Follow up information was received from a physician concerning the 15 year old female patient with penicillin allergy, sulfonamide allergy, allergy to cephalasporin and a history of adverse reaction to GARDASIL WAES#0902USA01435) who on 16-MAR-2009 was vaccinated intramuscularly in the left arm with the first dose of VARIVAX (Merck). There was no illness at the time of vaccination. On 15-JAN-2009 the patient developed 8.5 by 7.0 cm erythematous induration. Lab test showed that the patient''s complete blood cell count (CBC) was normal but her erythrocyte sedimentation rate was greater than 31. The patient recovered 26-JAN-2009. Additional information has been requested.

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