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This is VAERS ID 279161

Case Details

VAERS ID: 279161 (history)  
Form: Version 1.0  
Age: 21.0  
Gender: Female  
Location: Florida  
   Days after vaccination:3
Submitted: 2007-05-14
   Days after onset:39
Entered: 2007-05-17
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Erythema, Rash generalised
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
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0704USA01001

Write-up: Information has been received from a physician, via a company representative, concerning a 21 year old female patient, who on 05-FEB-2007 was vaccinated IM, with the first dose of Gardasil, and on 02-APR-2007 with the second dose of Gardasil (Lot #654535/0136U). Concomitant therapy included an antibiotic containing sulfa (unspecified). On 05-APR-2007, three days later after the second dose was administered, the patient developed a red rash from her chin to her toes. The physician indicated he believed "the antibiotic containing sulfa" was "the cause of the rash." At the time of the report, it unknown if the patient had recovered. The patient sought unspecified medical attention. Additional information has been requested.

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