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This is VAERS ID 271140

Case Details

VAERS ID: 271140 (history)  
Form: Version 1.0  
Age: 19.0  
Gender: Female  
Location: New York  
Vaccinated:2006-12-18
Onset:2006-12-20
   Days after vaccination:2
Submitted: 2007-01-16
   Days after onset:27
Entered: 2007-01-22
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 654540/1161F / 1 - / -

Administered by: Other       Purchased by: Other
Symptoms: Injection site pruritus
SMQs:

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: Lexapro, Prevacid, Toprol XL tablets, Singulair
Current Illness:
Preexisting Conditions: Asthma; Depression; Drug hypersensitivity
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type: WAES0612USA03353

Write-up: Information has been received from a nurse concerning a 19 year old female patient with asthma, depression and allergies to valproate sodium, diazepam, gabapentin and acetaminophen (+) butalbital (+) caffeine who on 18-DEC-2006 was vaccinated with her first dose of HPV rL1 6 11 16 18 VLF vaccine (yeast), 1pt #654540/1161F. Concomitant therapy included montelukast sodium (MSD), escitalopram oxalate, lansoprazole, and metoprolol succinate. On 20-DEC-2006 the patient called the office and stated that the injection site was itchy. Medical attention was sought. The physician''s office to follow up with patient, her outcome was unknown. Additional information has been requested.


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