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This is VAERS ID 278528

Case Details

VAERS ID: 278528 (history)  
Form: Version 1.0  
Age: 22.0  
Gender: Female  
Location: Florida  
Vaccinated:2007-04-25
Onset:2007-04-26
   Days after vaccination:1
Submitted: 2007-05-09
   Days after onset:13
Entered: 2007-05-14
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0384U / 1 RA / IM

Administered by: Private       Purchased by: Private
Symptoms: Pruritus, 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? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Depo Provera
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Pt developed hives and itching the day after vaccine was administered. Began taking Benadryl OTC x 3 days with no relief. On 04/30/07 went to ER. She was prescribed Atarax x 14 days. By May 6, 2007 all symptoms had been resolved.


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