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This is VAERS ID 270250

Case Details

VAERS ID: 270250 (history)  
Form: Version 1.0  
Age: 24.0  
Gender: Unknown  
Location: Florida  
   Days after vaccination:1
Submitted: 2007-01-05
   Days after onset:38
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: Hypersensitivity, Pruritus
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: NONE
CDC Split Type: WAES0612USA00494

Write-up: Information has been received from a physician concerning a 24 year old patient who on 27 Nov 2006 was vaccinated in the arm with the first dose of HPV Vaccine. There was no concomitant medications. On 28 Nov 2006, it was reported that the patient developed generalized itching throughout her body. The patient called the physician on the following day and reported she was itchy. The physician stated that she believed the patient experienced an allergic reaction and dose not want to give the second and third shot. It was reported that the patient sought unspecified medical attention. It was reported that a couple of days later, the patient had recovered. Additional information has been requested.

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