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This is VAERS ID 281020

Case Details

VAERS ID: 281020 (history)  
Form: Version 1.0  
Age: 15.0  
Gender: Female  
Location: New York  
   Days after vaccination:0
Submitted: 2007-06-07
   Days after onset:17
Entered: 2007-06-08
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Pruritus, 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? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type: WAES0705USA05241

Write-up: Information has been received from a physician concerning a 15 year old female with no pertinent medical history or drug reactions/allergies, who on 21-MAY-2007 was vaccinated intramuscularly with the first dose of Gardasil. There was no concomitant medication. On 21-MAY-2007 the patient developed a rash that started on the belly and spread to the back and both legs. The physician noted that it was unknown whether the rash was already there before the patient received the vaccination, however the patient noticed the rash and mild itching the day that the vaccination was given. The patient was given cetirizine hydrochloride (ZYRTEC). At the time of this report, the patient''s rash and itching persisted. The reporting physician felt that the events were serious for another other medical event due to treatment with cetirizine hydrochloride (ZYRTEC). Additional information has been requested.

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