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This is VAERS ID 272847

Case Details

VAERS ID: 272847 (history)  
Form: Version 1.0  
Age: 23.0  
Gender: Female  
Location: Colorado  
Vaccinated:2007-02-15
Onset:2007-02-18
   Days after vaccination:3
Submitted: 2007-02-21
   Days after onset:3
Entered: 2007-02-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0962F / 1 RA / IM

Administered by: Private       Purchased by: Unknown
Symptoms: Injection site pain, Injection site rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (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? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Routine Pap smear
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: HPV vaccine given 2/15/07. PT called office 2/20/07 with reports of "breaking out from vaccine". States on 2/18 she had hives on waist up, dry and flaky. Only "pain and pimple" at injection site (R arm). Pt denied any other changes in detergents, soap, food, perfume, lotion, etc. Pt told to take Benadryl.


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