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This is VAERS ID 282963

Case Details

VAERS ID: 282963 (history)  
Age: 12.0  
Gender: Female  
Location: New Jersey  
Vaccinated:2007-06-16
Onset:2007-06-16
   Days after vaccination:0
Submitted: 2007-06-18
   Days after onset:2
Entered: 2007-06-27
   Days after submission:9
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0525U / 0 - / IM

Administered by: Private       Purchased by: Private
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Received 1st Gardasil shot in office around 11AM Later that day broke out with hives all over her torso and arms. Mom called Dr - Dose of Benadryl was administered. Hives faded no other reaction reported. Spoke with mom on 6/18/07 child was fine.


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