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This is VAERS ID 270242

Case Details

VAERS ID: 270242 (history)  
Form: Version 1.0  
Age:   
Gender: Female  
Location: Indiana  
Vaccinated:2006-12-01
Onset:2006-12-01
   Days after vaccination:0
Submitted: 2007-01-05
   Days after onset:35
Entered: 2007-01-09
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / -

Administered by: Other       Purchased by: Other
Symptoms: 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? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data:
CDC Split Type: WAES0612USA00294

Write-up: Information has been received from a physician concerning a female patient (age and demographics not reported) who on 01-Dec-2006 was vaccinated with the first dose of HPV vaccine (yeast) (Lot# not reported). On 01-Dec-2006 immediately after being vaccinated the patient developed widespread hives. No respiratory difficulty was noted. The patient was transported to the emergency room for evaluation and was not admitted to the hospital. At the time of this report the patient had not recovered from the hives. Additional information has been requested.


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