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This is VAERS ID 283972

Case Details

VAERS ID: 283972 (history)  
Form: Version 1.0  
Age: 25.0  
Gender: Female  
Location: New Jersey  
Vaccinated:2007-02-04
Onset:2007-02-04
   Days after vaccination:0
Submitted: 2007-06-14
   Days after onset:129
Entered: 2007-06-18
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Urticaria, Vaccine positive rechallenge
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: hormonal contraceptives
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0705USA02950

Write-up: Information has been received from a physician concerning a 25 year old female with no known allergies who on 04-FEB-2007 was vaccinated with the first dose of Gardasil. Concomitant therapy included hormonal contraceptives (unspecified). On 04-FEB-2007 the patient broke out in hives after the first dose of Gardasil. On 08-MAY-2007, the patient was vaccinated with the second dose of Gardasil. Within one day, the patient broke out into hives after the second dose. Medical attention was sought. The physician treated the patient with Zyrtec and oral steroids. As of 15-MAY-2007, the patient was recovering. Additional information has been requested.


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