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This is VAERS ID 272601

Case Details

VAERS ID: 272601 (history)  
Form: Version 1.0  
Age:   
Gender: Female  
Location: Virginia  
Vaccinated:2007-01-18
Onset:2007-01-18
   Days after vaccination:0
Submitted: 2007-02-14
   Days after onset:27
Entered: 2007-02-15
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK - / -

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: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC Split Type: WAES0701USA04996

Write-up: Information has been received from a physician concerning a female (age not reported) with pertinent medical history and drug reactions/allergies unspecified who on approximately 18-JAN-2007 was vaccinated with Gardasil (yeast) (lot # not reported). On approximately 18-JAN-2007, the patient experienced a rash all over her body. The outcome of the rash was unknown. Additional information has been requested.


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