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This is VAERS ID 274215

(NOTE: This result is from the 5/14/2017 version of the VAERS database)

Case Details

VAERS ID: 274215 (history)  
Form: Version .0  
Age: 22.0  
Gender: Female  
Location: North Carolina  
   Days after vaccination:3
Submitted: 2007-03-14
   Days after onset:30
Entered: 2007-03-16
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Erythema, Injection site discolouration, Melanocytic naevus, Pain, Rash, Skin hyperpigmentation
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? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: hormonal contraceptives
Current Illness: Asthma
Preexisting Conditions: Cervical intraepithelial neoplasia; Benign pigmented naevus excision
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0702USA02321

Write-up: Information has been received from a physician concerning a 22 year old female with mild asthma and a history of CIN grade I (2003, 2005 and 2006) and a benign pigmented lesion removed from her inner thigh (2006) who on 08-FEB-2007 was vaccinated IM into the right arm with a 0.5 ml dose of Gardasil (yeast) (lot # 654535/0960F). Concomitant therapy included oral hormonal contraceptives (unspecified). Three on 11-FEB-2007 the patient developed two raised areas of hyperpigmented skin in the area of the injection site. The areas are 4 x 4 mm and 3 x 3 mm. The areas are described as are nevus like in appearance, linear, surrounded by erythema and painful. The patient is being evaluated for a "possible skin rash." The patient had not yet recovered from her experiences. Additional information has been requested.

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