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This is VAERS ID 536493

Case Details

VAERS ID: 536493 (history)  
Form: Version 1.0  
Gender: Male  
Location: Foreign  
   Days after vaccination:6
Submitted: 2014-07-12
   Days after onset:73
Entered: 2014-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Pruritus, Rash erythematous
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? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Prophylaxis
Preexisting Conditions: Varicella, 2-3 years old
Diagnostic Lab Data:
CDC Split Type: WAES1407AUS004067

Write-up: Information was obtained on a request by the Company from the agency via a Public Case Detail concerning a Male patient of unkonwn age. Previous varicella disease 2-3 year old. On 24-APR-2014 the patient was vaccinated with GARDASIL dose 1, intramuscular. Other suspect therapies included VARILRIX dose 1. On 30-APR-2014, the patient experienced red spots with white head on back, shoulders and small amount on neck, itchy (disability). School has excluded child for 1 week parent seeking advice. Advised to wait until lesions dry before returning to school. The outcome of the event was reported as not recovered/not resolved. The reporter considered the event to be related to GARDASIL. Additional information is not expected.

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