National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 284100

Case Details

VAERS ID: 284100 (history)  
Form: Version 1.0  
Age: 18.0  
Gender: Female  
Location: Alabama  
Vaccinated:2007-06-26
Onset:2007-06-26
   Days after vaccination:0
Submitted: 2007-07-06
   Days after onset:10
Entered: 2007-07-09
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0524U / 1 UN / IM

Administered by: Other       Purchased by: Other
Symptoms: Pruritus, 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: LEXAPRO; SEASONALE; PROTONIX
Current Illness: Gastrooesophageal reflux; Depression; Penicillin allergy
Preexisting Conditions: Gastrooesophageal reflux; Depression; Penicillin allergy
Allergies:
Diagnostic Lab Data: None
CDC Split Type: WAES0706USA05121

Write-up: Information has been received from a licensed practical nurse concerning an 18 year old female with gastrooesophageal reflux, depression and a penicillin allergy who on 26-JUN-2007 was vaccinated intramuscularly with the first 0.5 ml dose of the GARDASIL (Lot # 658094/0524U). Concomitant therapy included LEXAPRO, SEASONALE and PROTONIX. Forty minutes after receiving the vaccination, the patient developed widespread hives and itching. The patient was evaluated in the local emergency room and was given intravenous steroid treatment. The patient was not admitted to the hospital. No laboratory or diagnostic tests were performed. The patient outcome was unknown. The licensed practical nurse considered the widespread hives and itching to be other important medical events. Additional information has been requested.


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=284100


Copyright © 2017 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166