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This is VAERS ID 272583

Case Details

VAERS ID: 272583 (history)  
Form: Version 1.0  
Age: 17.0  
Gender: Female  
Location: Washington  
   Days after vaccination:0
Submitted: 2007-02-14
   Days after onset:65
Entered: 2007-02-15
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Blister, Burning sensation, Herpes zoster, Urticaria
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Hypersensitivity (narrow), 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? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: YASMIN 28; Sulfamethoxazole
Current Illness: Smoker
Preexisting Conditions: Rash; Diarrhoea; Chickenpox
Diagnostic Lab Data: UNK
CDC Split Type: WAES0701USA04672

Write-up: Information has been received from a nurse practitioner concerning an 18 year old female patient who was vaccinated with her first dose of HPV vaccine (yeast) and had no adverse side effects. Subsequently, she was vaccinated with her 2nd dose of HPV vaccine (yeast) and within 24 hours broke out in hives, which developed into shingles. Medical attention was sought. As of the report date, the patient was recovering. Additional information has been requested. Follow up information has been received from a Certified Medical Assistant and medical records concerning a 17 year old female stundent with current tobacco use and a history of rash with CEFZIL and CECLOR, diarrhoea with AUGMENTIN and chickenpox who on 11-DEC-2004 at 2:35 p.m. was vaccinated IM in left arm with her second dose of GARDASIL, lot #653735/068HF. Concomitant therapy included YASMIN 28 and Sulfamethoxazole and trimethoprim. The reporter indicated that the patient developed hives post injection, then on 18-DEC-2006 was seen at an urgent care clinic for shingles, which was not felt to be related to the immunization. The patient recovered on an unspecified date. According to medical notes from 18-DEC-2006. Patient states she''s here for compains of a rash on her back and under her right armpit, and she describes the pain as an 8/10. States it started last Wednesday (13-DEC-2006) but it''s gotten much worse. States she had the 2nd HPV immunization last Monday, and they wonder if this might be a reaction to it. "It was also reported that the patient did have a burning/pain sensation prior to 13-DEC-2006 and prior to the administration of GARDASIL and blistering. The blisters were in clumps/painful, and were aggravated by touching. The patient stated she was under a lot of stress with school and that she had some low grade fevers. Her assessment was shingles, right T5 dermatone - increase vesicles in patches along the T5 dermatone. She was treated with VALTREX. 1 tablet 3 times daily and Tylenol with Codeine #3). 1 tablet every 4 hours as needed for pain. Additional information is not expected.

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