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This is VAERS ID 282665

Case Details

VAERS ID: 282665 (history)  
Form: Version 1.0  
Age: 22.0  
Gender: Female  
Location: New York  
Vaccinated:2007-06-18
Onset:2007-06-18
   Days after vaccination:0
Submitted: 2007-06-18
   Days after onset:0
Entered: 2007-06-22
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0523U / 2 LA / IM

Administered by: Private       Purchased by: Unknown
Symptoms: Injection site erythema, Injection site rash, No reaction on previous exposure to drug
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)

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: Yasmin 28
Current Illness: None
Preexisting Conditions: Penicillin
Allergies:
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Pt developed red unraised rash immediately after vaccine was given on her left deltoid. Rash completely resolved after 10 min. No reaction after first dose. Tested other arm for sensitivity to alcohol without reaction.


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