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This is VAERS ID 271631

Case Details

VAERS ID: 271631 (history)  
Form: Version 1.0  
Age: 11.0  
Gender: Female  
Location: New York  
Vaccinated:2007-01-06
Onset:2007-01-07
   Days after vaccination:1
Submitted: 2007-01-29
   Days after onset:22
Entered: 2007-02-02
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS 1210F / 1 - / -
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1424F / 1 - / -

Administered by: Private       Purchased by: Private
Symptoms: Abdominal pain upper, Headache, Malaise, Pruritus, Rash generalised, Sneezing, Throat irritation
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Very severe skin rash covering the entire body. Itchy skin, some sneezing scratchy throat. Headache, stomach ache overall feeling of being unwell. After 4 days rash not gone. Treatment: Benadryl every 5 hours, Aveeno baths.


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