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This is VAERS ID 270264

Case Details

VAERS ID: 270264 (history)  
Form: Version 1.0  
Age: 25.0  
Gender: Female  
Location: Tennessee  
Vaccinated:2006-11-06
Onset:2006-11-06
   Days after vaccination:0
Submitted: 2007-01-05
   Days after onset:60
Entered: 2007-01-09
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 - / IM

Administered by: Other       Purchased by: Other
Symptoms: Nausea, Pruritus
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad), 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: UNK
CDC Split Type: WAES0612USA01069

Write-up: Information has been received from a physician and a nurse concerning a 25 year old female who on 06 Nov 2006 was vaccinated intramuscularly with the first single dose vial of Gardasil. On 06 Nov 2006, that evening, the patient developed itching all over her body, but no rash was associated with it. The physician and nurse reported that the patient also developed nausea. Unspecified medical attention was sought. The nurse told the patient to try some over the counter Benadryl to treat the itching as was recommended by the physician. There was no lot number provided. At the time of this report, the outcome of the events were unknown. Additional information has been requested.


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