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This is VAERS ID 276128

Case Details

VAERS ID: 276128 (history)  
Age: 20.0  
Gender: Female  
Location: Illinois  
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. - / - UN / IM

Administered by: Other       Purchased by: Other
Symptoms: Herpes zoster
SMQs:

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Diagnostic Lab Data:
CDC Split Type: WAES0703USA00447

Write-up: Information has been received from a pharmacist concerning a 20 year old female with pertinent medical history not reported and drug reactions/allergies reported as none who on an unspecified date was vaccinated with HPV rL1 6 11 18 VLP vaccine (yeast), 0.5 ml, IM. Concomitant medication was not reported. Approximately on week after vaccination, the patient reported that she experienced shingles. The outcome and causality of the event was not reported. Additional information has been requested.


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