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This is VAERS ID 272510

Case Details

VAERS ID: 272510 (history)  
Form: Version 1.0  
Age: 26.0  
Gender: Female  
Location: Virginia  
Vaccinated:2007-01-19
Onset:2007-01-21
   Days after vaccination:2
Submitted: 2007-02-14
   Days after onset:24
Entered: 2007-02-15
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 1 LA / IM

Administered by: Private       Purchased by: Private
Symptoms: Erythema, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0701USA03965

Write-up: Information has been received from a physician concerning a 26 year old female who on 19-JAN-2007 was vaccinated intramuscularly in left arm (upper outer quadrant) with the first dose of GARDASIL vaccine (lot # 655619/1427F). On approximately 21-JAN-2007, "within about three days", the patient reported that both her arms were itchy and red. The patient sought unspecified medical attention. The physician reported that she told the patient to take some BENADRYL to treat the symptoms. The physician reported that she did not plan to re-vaccinate the patient with GARDASIL vaccine. No lot number was provided. At the time of this report, the outcome of the event was unknown. Additional information has been requested. This is in follow-up to report (s) previously submitted on 2/14/2007. Additional information was received from a health professional. Lot number was provided and added to the report. The injection site was more affected that the opposite arm. The outcome was not reported. No additional information is expected.


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