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This is VAERS ID 275373

Case Details

VAERS ID: 275373 (history)  
Age: 11.0  
Gender: Female  
Location: Connecticut  
Vaccinated:2007-03-22
Onset:2007-03-24
   Days after vaccination:2
Submitted: 2007-03-30
   Days after onset:6
Entered: 2007-04-02
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0244U / 0 LA / IM

Administered by: Private       Purchased by: Private
Symptoms: Pruritus, Rash, Rash macular, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Albuterol inhaler, Prevacid
Current Illness: on 3/22/07 for epistaxis S/P trauma nose
Preexisting Conditions: Allergy Codeine (GI upset), HX GERD and exercise induced asthma.
Diagnostic Lab Data: None
CDC Split Type: CT200705

Write-up: Pt seen at office on 3/26/07 c/o itchy rash to face. Reports XS began 2 days previously. Seen by DR noted macular rash face and neck and ordered Benadryl, Prn.


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