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This is VAERS ID 274697

Case Details

VAERS ID: 274697 (history)  
Form: Version 1.0  
Age: 17.0  
Gender: Female  
Location: Colorado  
   Days after vaccination:6
Submitted: 2007-03-14
   Days after onset:14
Entered: 2007-03-16
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Food allergy, 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? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NYQUIL
Current Illness: Allergic to cats; Food allergy
Preexisting Conditions:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0702USA04286

Write-up: Information has been received from a nurse practitioner concerning a 17 year old female patient with allergies to cast and scallops who on 21-FEB-2007 was vaccinated with a dose of Gardasil. Concomitant therapy included NYQUIL. 20 hours later, the patient developed hives. Unspecified medical attention was sought. The patient''s hives persisted. The reporter indicated the patient had hives from the vaccine. Additional information has been requested.

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