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This is VAERS ID 276112

Case Details

VAERS ID: 276112 (history)  
Form: Version 1.0  
Age:   
Gender: Female  
Location: Kansas  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 2007-04-06
Entered: 2007-04-09
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / -

Administered by: Other       Purchased by: Other
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0703USA00199

Write-up: Information has been received from a physician via a company representative concerning a female patient who was vaccinated with the first dose. 0.5 ml, IM, of HPV rL1 6 11 16 18 VLP vaccine (yeast). Subsequently the patient "developed hives all over her body." At the time of this report, the patient had recovered. The patient sought unspecified medical attention. Additional information has been requested.


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