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This is VAERS ID 271116

Case Details

VAERS ID: 271116 (history)  
Age: 21.0  
Gender: Female  
Location: New York  
Vaccinated:2006-11-24
Onset:2006-11-25
   Days after vaccination:1
Submitted: 2007-04-06
   Days after onset:131
Entered: 2007-01-22
   Days after submission:73
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0954F / 0 UN / IM

Administered by: Private       Purchased by: Private
Symptoms: Acne
SMQs:

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: Upper respiratory tract infection
Preexisting Conditions: UNK
Diagnostic Lab Data: NONE
CDC Split Type: WAES0612USA02574

Write-up: Information has been received from a physician concerning a 22 year old female who on an unknown date was vaccinated with a first dose of Gardasil vaccine (yeast). Subsequently, the patient broke out with acne all over her face. Unspecified medical attention was sought. No diagnostic studies were performed. No product quality complaint was involved. Additional information has been requested. This is in follow-up to report (s) previously submitted on 1/16/2007. Information has been received from a physician concerning a 22 year old female student with a recent upper respirtatory infection and no allergies, who on 24-NOV-2006 was vaccinated IM into the left arm with a first dose of GARDASIL (lot # 653938/0954F). On 25-NOV-2006, the patient broke out with acne all over her face. It was noted that the patient and her mother stated that the patient does not usually suffer from acne. Unspecified medical attention was sought. No diagnostic studies were performed. Subsequently, the patient recovered. No product quality complaint was involved. Additional information is not expected.


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