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This is VAERS ID 272351

Case Details

VAERS ID: 272351 (history)  
Form: Version 1.0  
Age: 20.0  
Gender: Female  
Location: New York  
Vaccinated:2007-01-08
Onset:2007-01-10
   Days after vaccination:2
Submitted: 2007-02-14
   Days after onset:35
Entered: 2007-02-15
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 1 - / IM

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
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: Micronor
Current Illness:
Preexisting Conditions: Blood pressure high, sulfonamide allergy.
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type: WAES0701USA02390

Write-up: Information has been received from a physician concerning a 20 year old female with high blood pressure and an allergy to sulfa. On 08-Jan-2007, the patient was vaccinated intramuscularly with a first 0.5 ml dose of Gardasil (lot #655619/1427F). Concomitant therapy included Micronor. On 10-JAN-2007, the patient developed intermittent hives. The patient sought unspecified medical attention. At the time of this report, the patient had not recovered from the event. Additional information has been requested.


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