This is VAERS ID 275992
| Days after submission:||1
|Vaccination / Manufacturer
||Lot / Dose
||Site / Route|
|HPV4: HPV (GARDASIL) / MERCK & CO. INC.
||- / 0
||UN / UN
Administered by: Other Purchased by: Other
Symptoms: Stevens-Johnson syndrome
SMQs:, Severe cutaneous adverse reactions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Life Threatening? No
Permanent Disability? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
Extended hospital stay? Yes
Other Medications: Unknown
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0704USA00776
Write-up: Information has been received from a physician concerning a friend of a friend''s 11 or 12 year old daughter who on approximately 04-MAR-2007 ("about 1 month ago") was vaccinated with a first dose of Gardasil. In approximately March 2007, the patient developed Stevens-Johnson Syndrome and was hospitalized. Her recovery status was unknown at the time of the report. Additional information has been requested.
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