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This is VAERS ID 279917

Case Details

VAERS ID: 279917 (history)  
Age: 17.0  
Gender: Female  
Location: Minnesota  
Vaccinated:2007-05-25
Onset:2007-05-25
   Days after vaccination:0
Submitted: 2007-05-29
   Days after onset:4
Entered: 2007-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0181U / 0 LA / IM

Administered by: Private       Purchased by: Public
Symptoms: Rash, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Depo Provera (given 5/7/07)
Current Illness: no
Preexisting Conditions: LSIL PAP on 11-15-06.
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Patient received Gardasil dose #1 Friday(5/25/07) and developed pinpoint, intensely pruritic rash on thighs to knees. Did not extend up onto trunk, did not extend below knees. Presented to clinic this afternoon (first day open after holiday) with concern.


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