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This is VAERS ID 283796

Case Details

VAERS ID: 283796 (history)  
Form: Version 1.0  
Age: 19.0  
Gender: Female  
Location: Florida  
   Days after vaccination:4
Submitted: 2007-06-14
   Days after onset:40
Entered: 2007-06-18
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), 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: WAES0705USA01804

Write-up: Information has been received from a nurse practitioner concerning a 19 year old female with no pertinent medical history or a history of drug reactions or allergies who on 01-MAY-2007 was vaccinated with her first dose of Gardasil, 0.5 ml, IM, left deltoid. There was no concomitant medication. On 05-MAY-2007 the patient developed hives. The patient was instructed to take diphenhydramine (BENADRYL). No laboratory tests were done. As of 08-MAY-2007, the patient was recovering. Additional information has been requested.

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