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This is VAERS ID 272508

Case Details

VAERS ID: 272508 (history)  
Form: Version 1.0  
Age: 18.0  
Gender: Female  
Location: New York  
Vaccinated:2006-12-29
Onset:2006-12-29
   Days after vaccination:0
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. 1424F / 1 LA / IM

Administered by: Private       Purchased by: Private
Symptoms: Hypokinesia, Injection site urticaria, Malaise, Pain in extremity, Pyrexia, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), 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? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK; Flintstones Plus Iron; Cryselle
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: UNK; None
CDC Split Type: WAES0701USA03959

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 an 18 year old female with no past medical history who on 29-DEC-2006 at 10:00 AM was vaccinated with a first dose of GARDASIL (yeast) (lot # 654885/1424F), intramuscularly in the left arm. Concomitant therapy included CRYSELLE and "Flintstones multivitamins." There was no illness at the time of vaccination. On 29-DEC-2006 at 5:00 PM the patient initially developed hives around injection site, but then developed approximately 10 hives over entire body." It was also reported that the patient developed malaise and fever, also had a sore arm such that she felt she couldn''t move it for 24 hours. It was also reported that there were no other symptoms reported. There were no relevant diagnostic tests or laboratory date. The patient recovered on 30-DEC-2006. In follow up it was reported that the patient had been given a 2nd dose of GARDASIL with ZYRTEC and BENADRYL administration and had no reaction. Additional information is not expected. This is in follow-up to report(s) previously submitted on 2/14/2007. It was reported that "used 1% hydrocortisone cream but no oral meds, resolved by next day".


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