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This is VAERS ID 276243

Case Details

VAERS ID: 276243 (history)  
Age:   
Gender: Female  
Location: Florida  
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 / -

Administered by: Other       Purchased by: Other
Symptoms: Dermatitis allergic, Pityriasis rosea, Rash generalised
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data:
CDC Split Type: WAES0703USA04287

Write-up: Information has been received from a medical assistant concerning a female with vaccinated with Gardasil. Subsequently the patient developed a rash on her arm and part of the face. The rash spread to the rest of the body. The patient was diagnosed with allergic dermatitis and pityriasis rosea. Patient outcome was unknown. Additional information has been requested.


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