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This is VAERS ID 449034

Case Details

VAERS ID: 449034 (history)  
Form: Version 1.0  
Age: 14.0  
Gender: Female  
Location: California  
   Days after vaccination:1
Submitted: 2012-02-06
   Days after onset:11
Entered: 2012-02-07
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Cyanosis, Faecal incontinence, Fatigue, Hypoaesthesia, Injection site swelling, Oedema peripheral
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad), Noninfectious diarrhoea (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: Unknown
CDC Split Type: WAES1201USA04161

Write-up: Information has been received from a physician concerning a 14 year old female patient with no medical history who on 25-JAN-2012, was vaccinated with a first dose of GARDASIL, (lot number 668261/1397AA), (dose, route not reported) for prevention of HPV. Concomitant therapy included MENACTRA. On 26-JAN-2012, one day after receiving the first shot of GARDASIL, the patient experienced swelling at the injection site and numbness down the left arm and also on the lower left extremity. The patient also had swelling and purpling of the limbs and digits. The patient also was extremely fatigued and had uncontrollable bowel movements. On an unknown date, the patient was taken to the ER (hospital unknown) and was put on steroids and BENADRYL. Therapy with GARDASIL was not discontinued. At the time of the report the patient''s outcome was recovering. The patient sought medical attention. Swelling at the injection site and numbness down the left arm and also on the lower left extremity, swelling and purpling of the limbs and digits, extremely fatigued and uncontrollable bowel movements were considered to be disabling. Additional information has been requested.

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