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This is VAERS ID 276013

Case Details

VAERS ID: 276013 (history)  
Age: 17.0  
Gender: Female  
Location: Oregon  
Vaccinated:2007-03-13
Onset:2007-03-13
   Days after vaccination:0
Submitted: 2007-04-04
   Days after onset:22
Entered: 2007-04-11
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1426F / 0 RA / IM

Administered by: Private       Purchased by: Public
Symptoms: Pyrexia, Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Effexor XR 150 mg; Lexapro 10 mg; Ortho Evra Patch
Current Illness: None
Preexisting Conditions: Allergy Augmentin and Penicillin
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Moderate Fever, widespread rash/hives


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