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This is VAERS ID 267782

Case Details

VAERS ID: 267782 (history)  
Age: 17.0  
Gender: Female  
Location: Alabama  
Vaccinated:2006-11-13
Onset:2006-11-13
   Days after vaccination:0
Submitted: 2006-11-13
   Days after onset:0
Entered: 2006-11-27
   Days after submission:14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0702F / 0 RA / IM

Administered by: Private       Purchased by: Private
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), 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: Effexor XR
Current Illness: Dyspnea; Tonsillitis
Preexisting Conditions: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Overall fine body rash for past 2 days. Pt has a concomitant tonsillitis onset 2 days ago - negative strep


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