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This is VAERS ID 269218

Case Details

VAERS ID: 269218 (history)  
Age:   
Gender: Female  
Location: North Carolina  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 2006-12-14
Entered: 2006-12-18
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / -

Administered by: Other       Purchased by: Other
Symptoms: Injection site reaction, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), 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: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC Split Type: WAES0611USA06106

Write-up: Information has been received from a nurse concerning a female who on an unspecified date was vaccinated with HPV vaccine. Subsequently, one week later, the patient developed welts on the arm where the shot was administered. Unspecified medical attention was sought. At the time of this report, the outcome of the event was unknown. Additional information has been requested.


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