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This is VAERS ID 659267

Case Details

VAERS ID: 659267 (history)  
Age: 14.0  
Gender: Male  
Location: Florida  
Vaccinated:2014-01-25
Onset:2015-12-10
   Days after vaccination:684
Submitted: 2016-10-13
   Days after onset:307
Entered: 2016-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. J011272 / 2 AR / IM

Administered by: Unknown       Purchased by: Other
Symptoms: Biopsy bone marrow, Full blood count, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Allergy: phenergan, factor 9
Diagnostic Lab Data: CBC, bone marrow biopsy
CDC Split Type:

Write-up: Red rashes were noted on his body, would stay for days and then go away. 12/2015 we went to the allergist and labs were drawn.


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