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This is VAERS ID 264762

Case Details

VAERS ID: 264762 (history)  
Age: 26.0  
Gender: Female  
Location: Unknown  
Vaccinated:2006-09-25
Onset:2006-09-25
   Days after vaccination:0
Submitted: 2006-10-13
   Days after onset:18
Entered: 2006-10-17
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: Concurrent conditions: penicillin allergy
Diagnostic Lab Data: NONE
CDC Split Type: WAES0609USA05955

Write-up: Information has been received from a physician concerning a 26 year old female with a penicillin allergy who on 25-SEP-2006 was vaccinated with a dose of HPV rL1 6 11 16 18 VLP vaccine (yeast). Immediately post-vaccination, the patient experienced hives. The patient was treated with oral diphenhydramine hydrochloride (BENADRYL) and symptoms lessened. No diagnostic studies were performed. At the time of this report, the patient was recovering. No product quality complaint was involved. Additional information has been requested.


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