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This is VAERS ID 268992

Case Details

VAERS ID: 268992 (history)  
Form: Version 1.0  
Age: 14.0  
Gender: Female  
Location: Michigan  
Vaccinated:2006-11-22
Onset:2006-11-30
   Days after vaccination:8
Submitted: 2006-12-15
   Days after onset:15
Entered: 2006-12-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0954F / 1 LA / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Rash erythematous
SMQs:, Anaphylactic reaction (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: Zithromax, Orthotrycyclen
Current Illness: Dysmonorrhea, Sinusitis
Preexisting Conditions: Allergy to Cephalosporins, Penicillin and Sulfa
Allergies:
Diagnostic Lab Data: None
CDC Split Type:

Write-up: One week after injection, pt. has had a patchy, dry, erythemous rash 1 cm. in circumference show up intermittently on trunk and extremities. Rash remits and recurs. No history of rash.


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