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This is VAERS ID 269784

Case Details

VAERS ID: 269784 (history)  
Form: Version 1.0  
Age:   
Gender: Female  
Location: Florida  
Vaccinated:2006-12-12
Onset:2006-12-13
   Days after vaccination:1
Submitted: 2006-12-21
   Days after onset:8
Entered: 2006-12-28
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0961F / 1 LA / -

Administered by: Private       Purchased by: Private
Symptoms: Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), 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? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Yasmin
Current Illness:
Preexisting Conditions: Loestrin, Suprax, Pediazol.
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient developed hives starting at injection site and spreading over entire body. + itching. No respiratory symptoms. Patient used Benadryl without relief and was referred to her PCP for follow up.


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