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This is VAERS ID 276917

Case Details

VAERS ID: 276917 (history)  
Form: Version 1.0  
Age:   
Gender: Female  
Location: Pennsylvania  
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 - / IM

Administered by: Other       Purchased by: Other
Symptoms: Rash
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? No
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: WAES0703USA05275

Write-up: Information has been received from a registered nurse, via a company representative, concerning a female patient who was vaccinated with the first dose, IM, of Gardasil (date not specified). Subsequently the patient broke out into a rash on her neck and abdomen. The nurse stated that the patient was advised to take Benadryl as treatment. At the time of the report, it was unknown if the patient had recovered from the rash though the patient was scheduled to be seen in the office on 29-MAR-2007. Additional information has been requested.


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