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This is VAERS ID 283945

Case Details

VAERS ID: 283945 (history)  
Age: 14.0  
Gender: Female  
Location: New York  
Vaccinated:2007-05-10
Onset:2007-05-10
   Days after vaccination:0
Submitted: 2007-06-14
   Days after onset:35
Entered: 2007-06-18
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0962F / - UN / IM

Administered by: Other       Purchased by: Other
Symptoms: Feeling of body temperature change, Rash
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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Hormonal contraceptives
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type: WAES0705USA02397

Write-up: Information has been received from a physician''s assistant concerning a 14 year old female with no known drug allergies who on 10-MAY-2007 was vaccinated with a dose of GARDASIL, 0.5ml, intramuscularly (Lot# 654510/0962F). Concomitant therapy included hormonal contraceptives (unspecified). Within 24 hours of being vaccinated on 10-MAY-2007, the patient felt feverish and developed a small red rash on her abdomen, back and between her fingers. The patient''s mother treated her with over the counter BENADRYL. On 11-MAY-2007, the patient recovered. Additional information has been requested. 10/08/07 This is in follow-up to report(s) previously submitted on 6/14/2007. Additional information is not expected.


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