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This is VAERS ID 274735

Case Details

VAERS ID: 274735 (history)  
Form: Version 1.0  
Age: 25.0  
Gender: Female  
Location: New York  
   Days after vaccination:1
Submitted: 2007-03-14
   Days after onset:17
Entered: 2007-03-16
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Private       Purchased by: Private
Symptoms: Injection site erythema, Injection site pruritus, Injection site rash
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)

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: Cervical dysplasia; Penicillin allergy
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type: WAES0703USA00107

Write-up: Information has been received from a registered nurse concerning a female with high grade cervical dysplasia who on 23-FEB-2007 was vaccinated intramuscularly, into the left deltoid, with a first 0.5 ml dose of Gardasil (lot #653736/0014U). There was no concomitant medication. A few days after the vaccination, the patient developed a red, itchy, bumpy rash at the injection site. Unspecified medical attention was sought. There were no laboratory or diagnostic tests performed. At the time of the report, the patient''s outcome was unknown. Additional information has been requested. Follow-up received 04/03/2009. Subsequently the patient recovered. Penicillin allergy. No further information is available.

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