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This is VAERS ID 267454

Case Details

VAERS ID: 267454 (history)  
Form: Version 1.0  
Age: 20.0  
Gender: Female  
Location: Iowa  
Vaccinated:2006-09-22
Onset:2006-09-27
   Days after vaccination:5
Submitted: 2006-11-14
   Days after onset:48
Entered: 2006-11-16
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTOX: DIPHTHERIA TOXOIDS (NO BRAND NAME) / UNKNOWN MANUFACTURER C2491AA / 1 LA / IM
HEPAB: HEP A + HEP B (TWINRIX) / GLAXOSMITHKLINE BIOLOGICALS AHABB0583A / 1 RA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0702F / 1 LA / IM
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Pruritus generalised
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? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Asthma
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: None
CDC Split Type: WAES0610USA12643

Write-up: Information has been received from a physician concerning a female in her 20''s with intermittent problems with asthma and no known drug allergies, who on 22-SEPT-2006 at 13:00 was vaccinated IM into the left deltoid with a first dose of GARDASIL (Lot #653650/0702F). Concomitant therapy given that day included a first dose of DTaP (unspecified) given IM into the left arm, a first dose of TWINRIX (lot# AHABB0583A) given IM into the right arm and a first dose of typhoid vaccine. On 27-SEP-2006, the patient experienced intense itching all oer her body. The patient self medicated with BENADRYL. The itching was mostly on theinside of her legs and her back. She was treated with ZYRTEC. No diagnostic laboratory tests were pereformed. Subsequently, the patient fully recovered. No product qualitycomplaint was involved. It was noted that the vaccines were administered at different anatomical sites. Unspecified medical attention was sought. No diagnostic laboratory tests were performed. Additional information has been requested.


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