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This is VAERS ID 276657

Case Details

VAERS ID: 276657 (history)  
Form: Version 1.0  
Age: 16.0  
Gender: Female  
Location: Alabama  
   Days after vaccination:2
Submitted: 2007-04-13
   Days after onset:33
Entered: 2007-04-16
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Erythema multiforme, Rash generalised
SMQs:, Severe cutaneous adverse reactions (narrow), 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? Yes
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: WAES0703USA02134

Write-up: Information has been received from a physician and a registered nurse concerning a 16 year old female with no medical history or allergies, who on 08-MAR-2007 was vaccinated with a second dose of Gardasil. There was no concomitant medication. Two days after vaccination, the patient developed a rash all over her body. On 12-MAR-2007 the patient went to her primary care physician''s office and was diagnosed with erythema multiforme. The patient was treated with a dose pack of methylprednisolone (MEDROL) and subsequently recovered. No product quality complaint was involved. Additional information has been requested. Additional information is not expected.

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