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This is VAERS ID 276117

Case Details

VAERS ID: 276117 (history)  
Form: Version 1.0  
Age: 25.0  
Gender: Female  
Location: Pennsylvania  
Vaccinated:2007-03-01
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. 0187U / 1 LA / IM

Administered by: Public       Purchased by: Other
Symptoms: Rash, 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? Yes
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: WAES0703USA00336

Write-up: This is in follow-up to report(s) previously submitted on 4/6/2007. Initial and follow-up information has been received from a registered nurse concerning a 25 year old female teacher with asthma and hives when takes cefprozil who on 01-MAR-2007 was vaccinated intramuscularly in to left deltoid with a first dose of GARDASIL, (LOT# 656049/0187U). Concomitant therapy included montelukast sodium. Subsequently the patient experiences an 8 inch rash on hip area. The nurse reported that the patient developed hives from the therapy. The patient sought medical attention. The patient''s outcome was unknown. In follow-up it was indicated that patient reported 8" string of hives around left hip morning after she got the injection. Hives resolved with 25 mg BENADRYL. Hives had reoccurred several times since. The allergist felt above incident was coincidental with vaccine and unrelated. Patient will continue with series of GARDASIL. Additional information is not expected.


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