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This is VAERS ID 270063

Case Details

VAERS ID: 270063 (history)  
Age: 19.0  
Gender: Female  
Location: New Jersey  
Vaccinated:2006-12-01
Onset:2006-12-01
   Days after vaccination:0
Submitted: 2007-01-02
   Days after onset:32
Entered: 2007-01-04
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 0 LA / IM

Administered by: Private       Purchased by: Private
Symptoms: Headache, Nausea, Rash, Upper respiratory tract infection, Urticaria
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: Oral immunotherapy SLIT
Current Illness: NONE
Preexisting Conditions: Premature twin, environmental allergies.
Diagnostic Lab Data:
CDC Split Type:

Write-up: 12/01/2006 Nausea, headache, urticaria 12/04/2006. URI symptoms developed after rash. Treated with Benadryl, Prednisone, and Zyrtec. Phone call 1 week later, rash completely gone, urticaria due to vaccine VS intercurrent URI.


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