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This is VAERS ID 263235

(NOTE: This result is from the 12/30/2006 version of the VAERS database)

Case Details

VAERS ID: 263235 (history)  
Form: Version .0  
Age: 23.0  
Sex: Female  
Location: North Carolina  
Vaccinated:2006-08-24
Onset:2006-08-29
   Days after vaccination:5
Submitted: 2006-09-14
   Days after onset:16
Entered: 2006-09-19
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. - / - - / IM

Administered by: Other       Purchased by: Unknown
Symptoms: Rash
SMQs:, Anaphylactic reaction (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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Information has been received from a physician concerning a 23 year old female who on approximately 24-AUG-2006 was vaccinated with HPV rLi 6 11 16 18 VLP vaccine (yeast). On approximately 29-AUG-2006 (about 5 days after vaccination) the patient develope"d a rash (site of rash unspecified0. Unspecified medical attention was sought. At the time of this report, the outcome of the event was unknown. Additional information has been requested.


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20061230&IDNUMBER=263235


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