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This is VAERS ID 276349

Case Details

VAERS ID: 276349 (history)  
Form: Version 1.0  
Age: 21.0  
Gender: Female  
Location: Massachusetts  
Vaccinated:2007-03-19
Onset:2007-03-22
   Days after vaccination:3
Submitted: 2007-04-04
   Days after onset:13
Entered: 2007-04-16
   Days after submission:12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0263U / 2 LA / -

Administered by: Private       Purchased by: Public
Symptoms: Oral contraception, Pruritus, Rash, Rash macular
SMQs:, Anaphylactic reaction (broad), 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? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: Also on OLP (Yaz)
CDC Split Type:

Write-up: on 3/22/07 broke out in rash on right arms, upper chest and neck itchy. on 3/23/07-examined and very faint macular rash on arms, neck, upper trunk, not urticaria


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