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This is VAERS ID 272305

Case Details

VAERS ID: 272305 (history)  
Form: Version 1.0  
Age: 18.0  
Gender: Female  
Location: Massachusetts  
   Days after vaccination:1
Submitted: 2007-02-14
   Days after onset:36
Entered: 2007-02-15
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1425F / 1 - / IM

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? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: albuterol, hormonal contraceptives
Current Illness: Asthma
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type: WAES0701USA01015

Write-up: Information has been received from a registered nurse concerning an 18 year old female with asthma and no known allergies or adverse drug reactions reported. On 08-JAN-2007, the patient was vaccinated intramuscularly with the first 0.5 ml dose of Gardasil (yeast) (lot#655165/1425F). Concomitant therapy included hormonal contraceptives (unspecified) and albuterol. On 09-JAN-2007, the patient developed a rash on her back and chest. The patient sought unspecified medical attention. The patient was being treated with BENADRYL. At the time of this report, the patient had not recovered from the event.

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