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This is VAERS ID 284042

Case Details

VAERS ID: 284042 (history)  
Age: 13.0  
Gender: Female  
Location: Nevada  
Vaccinated:2007-07-05
Onset:2007-07-06
   Days after vaccination:1
Submitted: 2007-07-06
   Days after onset:0
Entered: 2007-07-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0962F / 2 RA / -

Administered by: Public       Purchased by: Unknown
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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: A hive type rash on her neck, both legs, both arms, elbow about 24 hours. Treatment: 50mg Benadryl Q6 PRN after 3rd HPV, urticaria type rash.


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