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This is VAERS ID 274587

Case Details

VAERS ID: 274587 (history)  
Form: Version 1.0  
Age: 16.0  
Gender: Female  
Location: Unknown  
   Days after vaccination:0
Submitted: 2007-03-14
   Days after onset:29
Entered: 2007-03-16
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0014U / UNK - / -

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
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: NONE
Current Illness:
Preexisting Conditions: Penicillin allergy
Diagnostic Lab Data: NONE
CDC Split Type: WAES0702USA04055

Write-up: Information has been received from a nurse practitioner concerning a 16 year old female with penicillin allergy who on 12-FEB-2007 was vaccinated with a dose of HPV (lot #653736/0014U). There was no concomitant medication. On 12-FEB-2007 the patient developed large hives on her arms, trunk and face. Medical attention was sought and the patient was treated with Benadryl 100 mg. There were no laboratory or diagnostic tests performed. On 13-FEB-2007, the patient recovered. Additional information has been requested.

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