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This is VAERS ID 279187

Case Details

VAERS ID: 279187 (history)  
Form: Version 1.0  
Age: 9.0  
Gender: Female  
Location: Unknown  
Vaccinated:2007-03-30
Onset:2007-04-02
   Days after vaccination:3
Submitted: 2007-05-14
   Days after onset:42
Entered: 2007-05-17
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0012U / UNK - / IM

Administered by: Other       Purchased by: Other
Symptoms: Rash generalised, Rash papular, 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? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Asthma
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0704USA01626

Write-up: Information has been received from a physician concerning a 9 year old female with asthma who on 30-MAR-2007 was vaccinated with Gardasil (Lot # 65503/0012U). Concomitant therapy included montelukast sodium. On approximately 02-APR-2007, within three to four days of vaccination with Gardasil, the patient experienced itchy, papular rash on face, extremities and body. The patient sought unspecified medical attention. The patient was treated with Benadryl. As of 10-APR-2007, the patient was recovering from itchy, papular rash on face, extremities and body. This is one of two reports from the same source. Additional information has been requested.


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