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This is VAERS ID 272295

Case Details

VAERS ID: 272295 (history)  
Form: Version 1.0  
Age: 25.0  
Gender: Female  
Location: New York  
Vaccinated:2006-12-22
Onset:2006-12-29
   Days after vaccination:7
Submitted: 2007-02-14
   Days after onset:47
Entered: 2007-02-15
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1425F / UNK UN / -

Administered by: Other       Purchased by: Other
Symptoms: Rash
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? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: Sulfonamide allergy
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type: WAES0701USA00778

Write-up: Information has been received from a physician concerning a female (age not reported) with a sulfonamide allergy and no other pertinent medical history reported. On 22-DEC-2006, the patient was vaccinated with 0.5ml of Gardasil ( Lot #655165/1425F). There were no concomitant medications reported. On 29-DEC-2006, one week after the injection, the patient developed a rash on her arms, legs and abdomen. The patient sought unspecified medical attention. It was reported that the rash had since cleared up but the date was unknown. At the time of this report, the patient had recovered from the event. Additional information has been requested. 5/14/10 Follow up: The patient took Benadryl for 24 hours and itching resolved. No diagnostic laboratory tests were performed. On 12-JAN-2007, the patient had recovered completely. Additional information is not expected.


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