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This is VAERS ID 272596

Case Details

VAERS ID: 272596 (history)  
Form: Version 1.0  
Age: 17.0  
Gender: Female  
Location: Indiana  
   Days after vaccination:15
Submitted: 2007-02-14
   Days after onset:60
Entered: 2007-02-15
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 - / IM

Administered by: Other       Purchased by: Other
Symptoms: Erythema nodosum
SMQs:, Hypersensitivity (narrow)

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: OVCON 50
Current Illness: Amenorrhea, Hirsutism, Allergic reaction to antibiotics
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type: WAES0701USA04857

Write-up: information has been received from a physician concerning a 17 year old female with amenorrhea, hirsutism and a CECLOR allergy who on 01-DEC-2006 was vaccinated IM with a first dose of Gardasil (yeast). The patient received Menactra concomitantly. Other concomitant therapy included Ovcon 50. On 16-DEC-2006 the patient developed erythema nodosum. The patient sought unspecified medical attention. The patient was treated with a course of steroids and has fully recovered. No laboratory diagnostic tests were performed. No product quality complaint was involved. Additional information has been requested.

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