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This is VAERS ID 279188

Case Details

VAERS ID: 279188 (history)  
Form: Version 1.0  
Age: 10.0  
Gender: Female  
Location: Unknown  
Vaccinated:2007-03-13
Onset:2007-03-16
   Days after vaccination:3
Submitted: 2007-05-14
   Days after onset:59
Entered: 2007-05-17
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0012U / UNK - / ID

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? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: Migraine
Allergies:
Diagnostic Lab Data: None
CDC Split Type: WAES0704USA01654

Write-up: Information has been received from a physician concerning a 10 year old female with a history of migraines who on 13-MAR-2007 was vaccinated with Gardasil. There was no concomitant medication. On approximately 16-MAR-2007, ''within 3 to 4 days", the patient developed an itchy, papular rash on her face, extremities and body. The patient sought medical attention and was treated with Benadryl. Subsequently, the patient was recovering. The product quality complaint unit was not involved. Additional information has been requested. The physician also provided information regarding another patient''s experience with Gardasil (WAES#0704USA01626).


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