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This is VAERS ID 284770

Case Details

VAERS ID: 284770 (history)  
Form: Version 1.0  
Age: 24.0  
Gender: Female  
Location: Pennsylvania  
   Days after vaccination:1
Submitted: 2007-06-28
   Days after onset:22
Entered: 2007-07-17
   Days after submission:19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Private       Purchased by: Private
Symptoms: Injection site rash, Pruritus, Rash erythematous, Rash pruritic
SMQs:, Anaphylactic reaction (broad), 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? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ORTHO TRI-CYCLEN LO
Current Illness: None
Preexisting Conditions: Seasonal allergies, otherwise none
Diagnostic Lab Data: None
CDC Split Type:

Write-up: GARDASIL shot on 6/5, 6/6 noticed bumps above shot area, (+) itch, 6/7 bumps spread across chest area. Patchy area on chest, red and bumpy. (+) itch Tx with hydrocortisone cream, CALADRYL cream + oatmeal baths. OTC itch cream. This is in follow-up to report (s) previously submitted on 7/16/2007. Information has been received from a consumer concerning her 24 year old daughter (also reported as 25) with no pertinent medical history or drug reactions and seasonal allergies who on 05-JUN-2007 was vaccinated with first dose of GARDASIL (lot# 656050/0245U) 0.5 ml in the left arm IM. Concomitant medication included ORTHO TRI-CYCLEN LO. The consumer reported that on 06-JUN-2007, the next day her daughter broke out in a rash all over her chest. Medical attention was not sought. At the time of reporting, the patient was recovering. Follow-up information was received from the Feedom of Information Act. The age, concomitant medication. lot number and allergies were updated. On 06-JUN-2007 bumps over the shot area was noticed and was itchy. On 07-JUN-2007 and bumps spread across the chest area. The patcy area on the chest was red, itchy and bumpy. Treatment for the rash include hydrocortisone cream, CALADRYL cream, and over the counter itch cream and oatmeal baths. The VAERS ID number is 284770. No additional information is expected.

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