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This is VAERS ID 276683

Case Details

VAERS ID: 276683 (history)  
Form: Version 1.0  
Age: 25.0  
Gender: Female  
Location: Texas  
Vaccinated:2007-03-12
Onset:2007-03-12
   Days after vaccination:0
Submitted: 2007-04-13
   Days after onset:32
Entered: 2007-04-16
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0187U / 1 UN / UN

Administered by: Private       Purchased by: Other
Symptoms: Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), 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: hormonal contraceptives; YAZ; vitamins (unspecified)
Current Illness: Contraception
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC Split Type: WAES0703USA02911

Write-up: This is in follow-up to report(s) previously submitted on 4/13/2007. Information has been received from a registered nurse concerning a 25 year old female police officer (151 lb, 62 inches), with no pertinent medical history, who on 12-MAR-2007 was vaccinated with a dose of GARDASIL (lot # 656049/0187U), left upper arm, in the morning. Concomitant therapy included hormonal contraceptives (YAZ). On 12-MAR-2007, in the afternoon or evening, the patient experienced severe itching in legs, feet, calves and hands. Unspecified medical attention was sought. After four days, on 15-MAR-2007, the patient recovered from the severe itching in calves, feet and hands. No product quality complaint was involved. Additional information is not expected.


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