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This is VAERS ID 275249

Case Details

VAERS ID: 275249 (history)  
Form: Version 1.0  
Age: 10.0  
Gender: Female  
Location: Alabama  
Vaccinated:2007-03-19
Onset:2007-03-19
   Days after vaccination:0
Submitted: 2007-03-29
   Days after onset:10
Entered: 2007-03-30
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0013U / 2 - / IM

Administered by: Other       Purchased by: Other
Symptoms: Injection site rash, Rash generalised
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? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Penicillin allergy
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: None
CDC Split Type: WAES0703USA04310

Write-up: Information has been received from a registered nurse concerning a 10 year old female with a penicillin allergy who on 19-MAR-2007 was vaccinated IM with a 0.5 ml second dose of Gardasil (Lot# 654741/0013U). There was no concomitant medication. On 19-MAR-2007 the patient developed a rash all over her body, especially near the injection site. The nurse reported that the patient was given BENADRYL for the rash. The patient went to see her pediatrician who reportedly prescribed the patient with prednisone an ZYRTEC. It was also reported that the patient did not have a reaction to her first dose of Gardasil. At the tiem of the report, the patient was recovering. The nurse felt that the patient''s rash was an other important medical event. Additional information has been requested.


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