National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 279640

Case Details

VAERS ID: 279640 (history)  
Form: Version 1.0  
Age: 11.0  
Gender: Female  
Location: Florida  
Vaccinated:2007-03-15
Onset:2007-04-09
   Days after vaccination:25
Submitted: 2007-05-14
   Days after onset:35
Entered: 2007-05-17
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / UNK UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Culture, Laboratory test, 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: diagnostic laboratory - results not reported, throat culture - results not reported
CDC Split Type: WAES0704USA06523

Write-up: This is in follow-up to report (s) previously submitted on 5/14/2007. Information has been received from a physician concerning a 11 year old female who on 15-MAR-2007 was vaccinated with GARDASIL (lot # 655619/1427F). On 09-APR-2007 the patient experienced a erythematous rash that spread from the injection site down one arm and then to the other arm. Medical attention was sought. The patient had unspecified blood work and had throat culture (results not reported). Subsequently, the patient recovered from rash. Additional information has been requested.


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=279640


Copyright © 2017 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166