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This is VAERS ID 271650

Case Details

VAERS ID: 271650 (history)  
Form: Version 1.0  
Age: 13.0  
Gender: Female  
Location: Massachusetts  
Vaccinated:2007-01-09
Onset:2007-01-14
   Days after vaccination:5
Submitted: 2007-02-02
   Days after onset:19
Entered: 2007-02-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / UNK RA / IM

Administered by: Private       Purchased by: Private
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 5 days after being administered the 2nd in a series of Gardasil developed hives requiring Benadryl and a visit to local ER. No facial edema, difficulty breathing or SOB occurred


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