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This is VAERS ID 274708

Case Details

VAERS ID: 274708 (history)  
Form: Version 1.0  
Age: 13.0  
Gender: Female  
Location: Kansas  
   Days after vaccination:0
Submitted: 2007-03-14
   Days after onset:25
Entered: 2007-03-16
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Private       Purchased by: Private
Symptoms: Rash pruritic
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? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data:
CDC Split Type: WAES0702USA04351

Write-up: Information has been received from an office manager concerning a 12 year old female who on an unspecified date was vaccinated with the first dose of Gardasil, injection. Concomitant medication was not reported. Subsequently on an unspecified date, the patient experienced a rash over body and legs that caused severe itching after Gardasil was administered. On an unspecified date, the patient sought unspecified medical attention. The patient''s rash over body and legs that caused severe itching persisted. Additional information has been requested. Information received 04/03/2009. The patient''s rash over body and legs that caused sever itching was gone within 4-5 days. Additional informaiton is not expected.

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