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This is VAERS ID 272328

Case Details

VAERS ID: 272328 (history)  
Age: 12.0  
Gender: Female  
Location: New York  
Vaccinated:2007-01-07
Onset:2007-01-07
   Days after vaccination:0
Submitted: 2007-02-14
   Days after onset:38
Entered: 2007-02-15
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - - / -

Administered by: Other       Purchased by: Other
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: diabetes, eczema
Diagnostic Lab Data: UNK
CDC Split Type: WAES0701USA01778

Write-up: Information has been received from a physician concerning a 12 year old female with diabetes and eczema who on approximately 07-JAN-2007 was vaccinated with a 0.5 ml dose of HPV rL1 6 11 16 18 VLP vaccine (yeast) concomitantly with a dose of an unspecified vaccine. On approximately 07-JAN-2007, later in the night, the patient developed hives all over her body, mostly on her legs. Unspecified medical attention was sought. At the time of the report, the patient''s outcome was unknown. Additional information has been requested.


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