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This is VAERS ID 278395

Case Details

VAERS ID: 278395 (history)  
Form: Version 1.0  
Age: 16.0  
Gender: Female  
Location: Indiana  
   Days after vaccination:1
Submitted: 2007-05-10
   Days after onset:49
Entered: 2007-05-11
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0014U / 1 RA / -

Administered by: Private       Purchased by: Other
Symptoms: Injection site pruritus, Injection site rash
SMQs:, Hypersensitivity (narrow)

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: Necon 50
Current Illness:
Preexisting Conditions: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient''s mother reported rash and itching at injection site approximately 6cm.

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