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This is VAERS ID 272594

Case Details

VAERS ID: 272594 (history)  
Form: Version 1.0  
Age: 21.0  
Gender: Female  
Location: Kentucky  
   Days after vaccination:3
Submitted: 2007-02-14
   Days after onset:17
Entered: 2007-02-15
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Rash generalised
SMQs:, Anaphylactic reaction (broad), 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: Yasmin, Wellbutrin
Current Illness:
Preexisting Conditions: Penicillin allergy.
Diagnostic Lab Data: UNK
CDC Split Type: WAES0701USA04781

Write-up: Information has been received from a certified medical assistant concerning a 21 year old female with penicillin allergy who on 25-JAN-2007 was vaccinated with first dose of Gardasil (lot #654702/0011U), 0.5 ml IM in the deltoid. Concomitant therapy included Yasmin and Wellbutrin. On 28-JAN-2007, three days later, the patient woke up with a rash on her entire body. The patient sought medical attention. The patient took Benadryl, but it had not improved. The medical assistant reported that the patient stated the rash is the same over her entire body, the injection site is not any worse than the rest of her body. At the time of reporting, the patient''s rash persisted. No further information was available at the time of reporting. Additional information has been requested.

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