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This is VAERS ID 279043

Case Details

VAERS ID: 279043 (history)  
Form: Version 1.0  
Age: 18.0  
Gender: Female  
Location: Minnesota  
Vaccinated:2007-04-01
Onset:2007-04-01
   Days after vaccination:0
Submitted: 2007-05-14
   Days after onset:43
Entered: 2007-05-17
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other       Purchased by: Other
Symptoms: 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? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC Split Type: WAES0704USA00397

Write-up: Information has been received from a consumer concerning her daughter, an 18 year old female, who on 01-APR-2007 was vaccinated with a dose, 0.5ml, of Gardasil. There was no concomitant medication. The consumer reported that on 01-APR-2007 after receiving the vaccination, her daughter "broke out in hives." At the time of this report, the consumer''s daughter had not recovered from the hives. The patient sought unspecified medical attention. Additional information has been requested.


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