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This is VAERS ID 276162

Case Details

VAERS ID: 276162 (history)  
Age: 13.0  
Gender: Female  
Location: Ohio  
Vaccinated:2007-02-14
Onset:2007-02-14
   Days after vaccination:0
Submitted: 2007-04-06
   Days after onset:50
Entered: 2007-04-09
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1447F / 0 RA / IM

Administered by: Private       Purchased by: Private
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Penicillin allergy
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0703USA01052

Write-up: Information has been received from a physician concerning a female patient who on 21-Feb-2007 was vaccinated with a dose of GARDASIL vaccine. The patient developed a single hive above her upper lip about 20 minutes after the injection. Unspecified medical attention was sought. The patient recovered. The physician did not know if the event was definitely related to the GARDSIL vaccine. Additional information has been requested. This is in follow-up to report (s) previously submitted on 4/6/2007. Initial and follow-up information has been received from a physician and a health care professional concerning a 13 year old female patient with Penicillin allergy who on 14-FEB-2007 was vaccinated IM in right deltoid with a first dose of 0.5 mL of GARDASIL vaccine, lot #655617/1447F. The patient developed a single hive above her upper lip aboout 20 minutes after the injection. No injection site reaction or other reactions noted. The patient was instructed to take BENADRYL by mouth which she took. She recovered the same day. The physician did not know if the event was definitely related to the GARDASIL vaccine. Additional information is not expected.


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