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This is VAERS ID 272610

Case Details

VAERS ID: 272610 (history)  
Form: Version 1.0  
Age:   
Gender: Female  
Location: Georgia  
Vaccinated:2007-01-26
Onset:2007-01-26
   Days after vaccination:0
Submitted: 2007-02-14
   Days after onset:19
Entered: 2007-02-15
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Pruritus, 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: WAES0702USA00039

Write-up: Information has been received from a physician concerning a female patient who on 26-JAN-2007 was vaccinated with a first dose of Gardasil (yeast). On 26-JAN-2007 the patient experienced itching and a rash around the area of the arm and the back of the knee. The rash continued to worsen and medication was ordered to treat the rash. At the time of this report, the patient''s outcome was unknown. It was noted that the patient will not receive the second and third dose of the vaccine. No product quality complaint was involved. Additional information has been requested. This is in follow-up to report (s) previously submitted on 2/14/2007. Information has been receivced from a physician concerning a female patient who on 26-JAN-2007 was vaccinated with a first dose of GARDASIL. On 26-JAN-2007 the patient experienced itching and a rash around the area of the arm and the back of the knee. The nurse stated that the rash began in the crevices of the elbows and knees and progressed to other parts of the body before the medicine was ordered to stop the itching. The rash continued to worsen and medication was ordered to treat the rash. At the time of this report, the patient''s outcome was unknown. It was noted that the patient will not receive the second and third dose of the vaccine. No product quality complaint was involved. Additional information has been requested.


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