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This is VAERS ID 273294

Case Details

VAERS ID: 273294 (history)  
Form: Version 1.0  
Age: 67.0  
Gender: Female  
Location: New York  
Vaccinated:2007-01-30
Onset:2007-02-03
   Days after vaccination:4
Submitted: 2007-03-02
   Days after onset:27
Entered: 2007-03-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / 1 RA / IM

Administered by: Private       Purchased by: Private
Symptoms: Blister, Erythema, Rash, Skin warm
SMQs:, Severe cutaneous adverse reactions (broad), 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Combivent inhaler, Advantage inhaler, Spiriva inhaler.
Current Illness: NONE
Preexisting Conditions: Asthma, Emphysema
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: 4 days after receiving Gardasil vaccine 1st injection patient c/o red, hot rash on both hands and upper thighs, rash on thighs with small blisters lasted approx 1 hour then subsided this went on daily for the next 10 days each time lasting 1 hour.


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