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This is VAERS ID 279181

Case Details

VAERS ID: 279181 (history)  
Form: Version 1.0  
Age: 22.0  
Gender: Female  
Location: Unknown  
   Days after vaccination:2
Submitted: 2007-05-14
   Days after onset:52
Entered: 2007-05-17
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 656372/0243U / 1 - / IM

Administered by: Private       Purchased by: Other
Symptoms: Rash
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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Penicillin allergy; Drug hypersensitivity
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type: WAES0704USA01530

Write-up: Information has been received from a healthcare worker concerning a 22 year old female with a penicillin allergy and Benadryl allergy and no pertinent medical history who on 21-MAR-2007 was vaccinated IM with 0.5 mL Gardasil (lot # 656372/0243U). There was no concomitant medication. On 25-MAR-2007 the patient developed a rash on her torso. No lab diagnostic studies were performed. The rash was treated with an injection of prednisone, and as of 29-MAR-2007 the patient was fully recovered. Additional information is not expected.

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