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This is VAERS ID 276847

Case Details

VAERS ID: 276847 (history)  
Form: Version 1.0  
Age: 23.0  
Gender: Female  
Location: Nebraska  
Vaccinated:2007-01-03
Onset:2007-01-03
   Days after vaccination:0
Submitted: 2007-04-13
   Days after onset:99
Entered: 2007-04-16
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1425F / 1 LA / IM

Administered by: Private       Purchased by: Other
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), 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? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: Cervical intraepithelial neoplasia
Allergies:
Diagnostic Lab Data: Unknown None
CDC Split Type: WAES0703USA03986

Write-up: Information has been received from a physician concerning a 23 year old female with a history of cervical intraepithelial neoplasia who on 03-JAN-2007 was vaccinated intramuscularly into the left arm with a first dose of GARDASIL vaccine (lot#655165/1425F)). There was no concomitant medication. On 03-JAN-2007 the patient experienced hives all over her body after vaccination with GARDASIL vaccine. The hives appeared all over her body on the day of vaccination. BENADRYL was prescribed to the patient and she fully recovered 48 hours after the vaccination. Additional information has been requested. This is in follow-up to report (s) previously submitted on 4/13/2007. No laboratory diagnositic studies were performed. The patient fully recovered 48 hours after the vaccination (also reported as 04-JAN-2007). No further information is available.


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