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This is VAERS ID 274210

Case Details

VAERS ID: 274210 (history)  
Age: 14.0  
Gender: Female  
Location: Florida  
Vaccinated:2007-01-03
Onset:2007-01-04
   Days after vaccination:1
Submitted: 2007-03-14
   Days after onset:68
Entered: 2007-03-16
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0954F / 0 UN / -

Administered by: Other       Purchased by: Other
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: Penicillin allergy; Allergic reaction to antibiotics
Preexisting Conditions:
Diagnostic Lab Data: UNK
CDC Split Type: WAES0702USA01925

Write-up: Information has been received from a physician concerning a 14 year old female patient with possible allergy to penicillin and erythromycin who on 03-JAN-2007 was vaccinated with a first dose of Gardasil (yeast), lot # 653938/0954F. The patient was not on any medication. On 04-JAN-2007 the patient developed hives. The patient was examined by the physician on 05-JAN-2007. The patient was reported as completely recovered by 06-JAN-2007. Additional information has been requested.


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