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This is VAERS ID 271577

Case Details

VAERS ID: 271577 (history)  
Form: Version 1.0  
Age: 19.0  
Gender: Female  
Location: Unknown  
   Days after vaccination:18
Submitted: 2007-01-28
   Days after onset:6
Entered: 2007-02-01
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0637F / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Rash erythematous, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), 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? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ovcon-35
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: On 1/4/2007, pt was given first dose of Gardasil vaccine. Also, on that day, changed OCP from Lo-ovral to Ovcon-35 because of spotting. Presnted 1/22/07 with pruitic rash consisting of tine erythematous papules on arms/legs/trunk

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