National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 602552

Case Details

VAERS ID: 602552 (history)  
Form: Version 1.0  
Age: 14.0  
Gender: Female  
Location: Washington  
Vaccinated:2013-12-17
Onset:2013-12-17
   Days after vaccination:0
Submitted: 2015-10-14
   Days after onset:665
Entered: 2015-10-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR UH899AB / 1 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. J008423 / 1 LA / IM

Administered by: Unknown       Purchased by: Other
Symptoms: Oropharyngeal pain, Respiration abnormal, Swollen tongue
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Hypersensitivity (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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: No
Preexisting Conditions: Head injury with nerve pain.
Allergies:
Diagnostic Lab Data: She was also given the flu shot for that year at the same time.
CDC Split Type:

Write-up: Started with throat hurting and by around 9 AM the next morning her tongue was swollen about 4 times the normal size. So large that she could not keep her tongue in her mouth and her breathing was affected.


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=602552


Copyright © 2017 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166