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This is VAERS ID 271168

(NOTE: This result is from the 12/8/2009 version of the VAERS database)

Case Details

VAERS ID: 271168 (history)  
Form: Version .0  
Age: 16.0  
Gender: Female  
Location: New Jersey  
Vaccinated:2006-12-14
Onset:2006-12-14
   Days after vaccination:0
Submitted: 2007-01-16
   Days after onset:33
Entered: 2007-01-22
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 6537360868F / - UN / -

Administered by: Other       Purchased by: Other
Symptoms: Allergy to vaccine
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
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: WAES0701USA00462

Write-up: Information has been received from an RN concerning a patient who has an allergic reaction after being vaccinated with a dose of Gardasil vaccine (yeast). The patient''s outcome was unknown. Additional information has been requested.


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Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20091208&IDNUMBER=271168


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