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This is VAERS ID 270033

Case Details

VAERS ID: 270033 (history)  
Age:   
Gender: Female  
Location: Virginia  
Vaccinated:2006-12-28
Onset:2006-12-28
   Days after vaccination:0
Submitted: 2006-12-28
   Days after onset:0
Entered: 2007-01-04
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0637F / 0 RA / IM

Administered by: Military       Purchased by: Military
Symptoms: Pruritus, Rash, 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? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Depo Provera times 2 years
Current Illness: NONE
Preexisting Conditions: Latex
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: 15 minutes after IM injection of Gardasil in right arm. Patient developed hives on her neck right side continued to move up on face. 20 minutes post injection rash and then itching over neck, face and back. Benadryl used IM. Vital signs remained stable.


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