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This is VAERS ID 263612

Case Details

VAERS ID: 263612 (history)  
Form: Version 1.0  
Age: 18.0  
Gender: Female  
Location: North Carolina  
Vaccinated:2006-09-01
Onset:2006-09-08
   Days after vaccination:7
Submitted: 2006-09-25
   Days after onset:17
Entered: 2006-09-26
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0637F / 1 LA / IM

Administered by: Other       Purchased by: Private
Symptoms: Blister, Erythema, Hypersensitivity, Rash erythematous
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Angioedema (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Singular, Zyrtec
Current Illness: NONE
Preexisting Conditions: Seasonal allergic rhinitis.
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: Raised erythematous patchy rash of left shoulder (Behind left deltoid muscle) with slight vesicles. Also similar linear rash on left leg (appearance of delayed hypersensitivity) rash began 1 week after injection.


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