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This is VAERS ID 274218

Case Details

VAERS ID: 274218 (history)  
Form: Version 1.0  
Age: 22.0  
Gender: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 2007-03-14
Entered: 2007-03-16
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK - / IM

Administered by: Other       Purchased by: Other
Symptoms: Rash
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: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC Split Type: WAES0702USA02437

Write-up: Information has been received from a physician''s assistant concerning a 22 year old female who on an unspecified date was vaccinated with Gardasil (yeast) (lot # not reported) IM injection. Concomitant therapy was unspecified. The patient sought unspecified medical attention. Subsequently, the patient experienced an extreme rash across her chest and up to her neck. At the time of reporting, the patient was "fine". Additional information has been requested.


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