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This is VAERS ID 284726

Case Details

VAERS ID: 284726 (history)  
Age: 16.0  
Gender: Female  
Location: New York  
Vaccinated:2004-07-10
Onset:2004-07-10
   Days after vaccination:0
Submitted: 2007-07-13
   Days after onset:1098
Entered: 2007-07-16
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0523U / 0 LA / UN

Administered by: Private       Purchased by: Private
Symptoms: Throat irritation, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (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: h/o seasonal allergies, Suprax
Diagnostic Lab Data:
CDC Split Type:

Write-up: pt had a few hives on 7/10/07-later in day after the Gardasil. Hives were worse on 7/11/07 with itch throat. Went to ER-given Benadryl and Prednisone x 7 days. pt also given an Epi Pen for future use.


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