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This is VAERS ID 276161

Case Details

VAERS ID: 276161 (history)  
Form: Version 1.0  
Age: 20.0  
Gender: Female  
Location: Maryland  
   Days after vaccination:51
Submitted: 2007-04-06
   Days after onset:41
Entered: 2007-04-09
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 2 - / IM

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: None
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type: WAES0703USA01048

Write-up: Information has been received from a licensed practical nurse, concerning a 20 year old female patient, who on 03-JAN-2007 was vaccinated with the first dose, 0.5 ml, IM, of Gardasil (Lot # 654389/0961F). There was no concomitant medication. On approximately 23-FEB-2007, the patient developed "hives that started approximately 1 week before her appointment for the second dose (02-MAR-2007). The nurse added that the patient''s "primary physician gave her an analgesic" (name unknown). The nurse stated that the patient"still had the hives when she came to the office" for her appointment and reported "the hives were mostly on both arms." The patient "received the second dose" of Gardasil on 02-MAR-2007. Additional information has been requested.

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