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This is VAERS ID 276677

Case Details

VAERS ID: 276677 (history)  
Form: Version 1.0  
Age:   
Gender: Female  
Location: Illinois  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 2007-04-13
Entered: 2007-04-16
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Rash maculo-papular, Rash pruritic
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? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0703USA02821

Write-up: Information has been received a physician concerning a female who was vaccinated with her first dose of Gardasil. Subsequently, "2 days later" the patient experienced pruritic and maculopapular rash. Unspecified medical attention was sought. The patient recovered from pruritic and maculopapular rash. No product quality complaint was involved. Additional information has been requested.


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