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This is VAERS ID 269205

Case Details

VAERS ID: 269205 (history)  
Age: 22.0  
Gender: Female  
Location: Illinois  
Vaccinated:2006-09-26
Onset:2006-09-26
   Days after vaccination:0
Submitted: 2007-04-06
   Days after onset:192
Entered: 2006-12-18
   Days after submission:108
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0689F / 0 - / IM

Administered by: Private       Purchased by: Private
Symptoms: Oedema peripheral, Pruritus, Rash generalised, Urticaria
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: None
CDC Split Type: WAES0611USA04701

Write-up: Information has been received from a registered nurse concerning a 22 year ld white female student with no other medical history, no known allergies or adverse drug reactions reported. On 26 Sep 2006, at 12:300 PM, the patient was vaccinated intramuscularly in the left deltoid with the first dose of Gardasil (yeast) (Lot# 653736/0689F), within 2 hours of the injections the patient developed full body hives, itching and swelling of hands and feet. The patient took Benadryl every 4 hours and the symptoms were gone within 24 hours. At the time of this report, the patient had recovered from the events. Additional information has been requested. This is in follow-up to report(s) previously submitted on 12/14/2006. Initial and follow up information has been received from a registered nurse concerning a 23 year old (previously reported as 22 year old) white female student with no other medical history, no known allergies or adverse drug reactions reported. On 26-SEP-2006, at 3:00 PM, the patient was vaccinated intramuscularly in the left deltoid with the first dose of GARDASIL (Lot # 653736/0689F). There were no illnesses noted at the time of vaccination. On 26-SEP-2006, at 4:00 PM, the patient developed a rash over body (previously) reported as full body hives and had itching) and had swelling of hands and feet. The patient took BENADRYL every 4 hours and the rash was gone within 24 hours. On 27-SEP-2006, the patient had recovered from the events. Additional information has been requested.


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