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This is VAERS ID 289947

Case Details

VAERS ID: 289947 (history)  
Form: Version 1.0  
Age: 16.0  
Gender: Female  
Location: Unknown  
Submitted: 2007-09-04
Entered: 2007-09-06
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Unknown       Purchased by: Unknown
Symptoms: Skin exfoliation
SMQs:, Severe cutaneous adverse reactions (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Penicillin allergy
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type: WAES0708USA05255

Write-up: Information has been received from a physician concerning a 16 year old female with penicillin allergy who on 14-AUG-2007 was vaccinated intramuscularly (IM) with the first dose of Gardasil (Lot #654702/0011U). Subsequently, the patient experienced peeling of the skin on the palms of both hands and the soles of both feet. The physician felt that this incident had caused a significant disability because it was very painful for the patient to walk with the skin on the soles of her feet peeling off. As of 28-AUG-2007, the patient had not recovered from the peeling of the skin on the palms of both hands and the soles of both feet. Additional information has been requested.

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