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This is VAERS ID 271129

Case Details

VAERS ID: 271129 (history)  
Age: 19.0  
Gender: Female  
Location: Pennsylvania  
Vaccinated:2006-12-15
Onset:2006-12-15
   Days after vaccination:0
Submitted: 2007-01-16
   Days after onset:32
Entered: 2007-01-22
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Laboratory test, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: diagnostic laboratory 12/??/06 - results not provided
CDC Split Type: WAES0612USA02967

Write-up: Information has been received from a physician concerning a 19 year old female with no persistent medical history or drug reactions/allergies, who on 15-Dec-2006 was vaccinated with Gardasil vaccine (yeast) (0.5 ml). There was no concomitant medication. On 15-Dec-2006, following vaccination, the patient developed a red itchy rash "all over". Unspecified medication attention was sought. At the time of this report the patient had not recovered. No additional information is available.


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