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This is VAERS ID 278994

Case Details

VAERS ID: 278994 (history)  
Form: Version 1.0  
Age: 13.0  
Gender: Female  
Location: California  
   Days after vaccination:0
Submitted: 2007-05-18
   Days after onset:4
Entered: 2007-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0384U / 2 LA / -

Administered by: Other       Purchased by: Other
Symptoms: Pruritus, Rash generalised, Rash macular, Rash pruritic
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? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: Ankle sprain, no allergies, birth defects
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Within 4 hours of receiving vaccine in left arm, received rash (red, macular, lacy) which was itching and extended to rest of her body lasting 3-4 days.

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