This is VAERS ID 267100

Case Details

VAERS ID:	267100 (history)
Form:	Version 1.0
Age:	21.0
Gender:	Female
Location:	Minnesota

Vaccinated:	2006-11-08
Onset:	2006-11-08
Days after vaccination:	0
Submitted:	2006-11-10
Days after onset:	2
Entered:	2006-11-17
Days after submission:	7

Vaccination / Manufacturer	Lot / Dose	Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC.	0688F / 1	LA / IM

Administered by: Private Purchased by: Private
Symptoms: Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Nuvaring, Allegra D, Albuterol, Nasonex
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt received vaccination early in AM. Called later that afternoon and was itching all over. took Benadryl which helped.

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