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This is VAERS ID 276900

Case Details

VAERS ID: 276900 (history)  
Form: Version 1.0  
Age: 23.0  
Gender: Female  
Location: Unknown  
Vaccinated:2007-02-05
Onset:2007-02-26
   Days after vaccination:21
Submitted: 2007-04-13
   Days after onset:45
Entered: 2007-04-16
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 1 UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Blister, Vulval disorder
SMQs:, Severe cutaneous adverse reactions (broad), Hypersensitivity (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: WAES0703USA04925

Write-up: Information has been received from a nurse practitioner concerning a 23 year old female who on 05-FEB-2007 was vaccinated with a first dose of Gardasil (lot# 655618/1427F). On 26-FEB-2007 the patient experienced three separate "vulvar-type blisters" which were "slightly raised" with a white, plaque-like surface. The patient was re-examined on 12-Mar-2007, and the above lesions had completely resolved. No product quality complaint was involved. Additional information has been requested.


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