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This is VAERS ID 276844

Case Details

VAERS ID: 276844 (history)  
Form: Version 1.0  
Age:   
Gender: Female  
Location: Massachusetts  
Vaccinated:2007-02-01
Onset:2007-02-01
   Days after vaccination:0
Submitted: 2007-04-13
   Days after onset:70
Entered: 2007-04-16
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Pain, Pruritus, Pyrexia, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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: (therapy unspecified)
Current Illness: Acne
Preexisting Conditions: Urticaria
Allergies:
Diagnostic Lab Data: None
CDC Split Type: WAES0703USA03976

Write-up: Information has been received from a certified medical assistant assistant and a physician concerning a female with acne and a history of urticaria (2004 unknown cause) who in February 2007 ("about 3 weeks ago"), was vaccinated IM with Gardasil. Concomitant therapy included unspecified antibiotic. Within a week the patient experienced urticaria, itchiness, low grade fever (100 F) and soreness. Subsequently, the patient recovered from urticaria, itchiness, low grade fever 100f and soreness. The patient sought unspecified medical attention. Additional information has been requested.


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