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This is VAERS ID 279557

Case Details

VAERS ID: 279557 (history)  
Form: Version 1.0  
Age: 21.0  
Gender: Female  
Location: Unknown  
Vaccinated:2007-04-18
Onset:2007-04-20
   Days after vaccination:2
Submitted: 2007-05-14
   Days after onset:24
Entered: 2007-05-17
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / UNK UN / IM

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? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: [therapy unspecified]; ORTHO TRI CYCLEN
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0704USA05707

Write-up: Information has been received from a health professional concerning a 21 year old female who on 18-APR-2007 was vaccinated with Gardasil (Lot #653978/0955F). Concomitant therapy included ORTHO TRI-CYCLEN. On the evening of 20-APR-2007 the patient experienced hives which were generalized on her trunk. The patient was instructed to take BENADRYL but it did not help. She was examined by a physician in the emergency room on 22-APR-07. She was not admitted. She was given ATARAX and prednisone. After the first dose of Atarax her rash resolved. It was reported that the patient took "CORICIDIN" (therapy unspecified) for the first time the morning of 20-APR-2007. the patient''s mother also stated that "her daughter often breaks out in hives". Additional information has been requested.


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