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This is VAERS ID 274374

Case Details

VAERS ID: 274374 (history)  
Form: Version 1.0  
Age: 23.0  
Gender: Female  
Location: Connecticut  
Vaccinated:2007-01-15
Onset:2007-01-22
   Days after vaccination:7
Submitted: 2007-03-19
   Days after onset:55
Entered: 2007-03-20
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 1 LA / IM

Administered by: Private       Purchased by: Private
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (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? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ORTHO TRICYCLEN
Current Illness:
Preexisting Conditions: Neurofibromytosis
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt received vaccine/GARDASIL 1/15/07. One week later, developed hives which lasted one week. Pt treated with BENADRYL for symptoms relief. Follow-up information received - Date of vaccination and Adverese event onset date.


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