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This is VAERS ID 274070

Case Details

VAERS ID: 274070 (history)  
Form: Version 1.0  
Age:   
Gender: Female  
Location: Indiana  
Vaccinated:2007-03-07
Onset:2007-03-07
   Days after vaccination:0
Submitted: 2007-03-15
   Days after onset:7
Entered: 2007-03-16
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 - / -

Administered by: Other       Purchased by: Other
Symptoms: Throat tightness, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), 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? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: Allergic reaction to antibiotics
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC Split Type: WAES0703USA01336

Write-up: Information has been received from a physician concerning a female (age not reported) with a history of allergic reaction to antibiotics who on 07-MAR-2007 was vaccinated with first dose of Gardasil (lot # not reported) injection. On 07-MAR-2007, after being vaccinated, the patient broke out in severe hives and her airway began to close. Medical attention was sought. The physician administered an injection of Benadryl. The patient was admitted to the emergency room, it was unknown if the patient was admitted to the hospital. On 08-MAR-2007, the patient recovered. No further information was provided. Upon internal review, airway began to close was considered to be an other important medical event. No further information is available.


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