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This is VAERS ID 272356

Case Details

VAERS ID: 272356 (history)  
Age: 13.0  
Gender: Female  
Location: Louisiana  
Vaccinated:2006-12-22
Onset:2006-12-22
   Days after vaccination:0
Submitted: 2007-02-14
   Days after onset:54
Entered: 2007-02-15
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0961F / - RA / IM

Administered by: Other       Purchased by: Other
Symptoms: Pain, Rash, 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? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0701USA02455

Write-up: This is in follow-up to report(s) previously submitted on 2/14/2007; 4/6/2007. Information has been received from a physician concerning a female patient with NKDA or preexisting medical conditions who on 22-DEC-2006, at 1:15 PM, the patient was vaccinated in the right arm with a 0.5 ml dose of GARDASIL (lot # 654389/0961F). Subsequently, several hours after the vaccination, she experienced localized right arm pain, developed a rash which was described as hives or her chin. Subsequently, on an unspecified date, the patient recovered from the events without treatment. The patient sought unspecified medical attention. Additional information is not expected. Additional information has been requested


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