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This is VAERS ID 272598

Case Details

VAERS ID: 272598 (history)  
Form: Version 1.0  
Age:   
Gender: Female  
Location: Georgia  
Vaccinated:2007-01-25
Onset:2007-01-27
   Days after vaccination:2
Submitted: 2007-02-14
   Days after onset:18
Entered: 2007-02-15
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK UN / -

Administered by: Other       Purchased by: Other
Symptoms: Rash
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: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC Split Type: WAES0701USA04926

Write-up: Information has been received from a physician concerning a female patient who on 26-JAN-2007 was vaccinated with a dose of Gardasil (yeast). On 27-JAN-2007 the patient developed a rash on her arm, chest and back. The patient sought unspecified medical attention. Additional information has been requested.


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