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This is VAERS ID 267288

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

Case Details

VAERS ID: 267288 (history)  
Form: Version .0  
Age: 25.0  
Sex: Female  
Location: Maryland  
Vaccinated:2006-09-29
Onset:2006-09-30
   Days after vaccination:1
Submitted: 2006-11-15
   Days after onset:46
Entered: 2006-11-20
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. 0800F / 0 UN / -

Administered by: Other       Purchased by: Unknown
Symptoms: Throat tightness, Tongue oedema, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal lesions, non-neoplastic, non-infectious and non-allergic (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Yasmin, Macrobid
Current Illness: Urinary tract infection
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Information has been received from a physicians assistant concerning a 25 year old female who on 9/29/06 was vaccinated with a first dose of HPV vaccine. Concomitant suspect therapy initiated a few days prior included nitrofurantoin (Macrobid) for the tre"atment of a urinary tract infection (dose not reported). Other concomitant therapy included drospirenone + ethinyl Estradiol (Yasmin). On 9/20/06 the pt called the physicians office to state that she had developed hives. The physicians office referred her


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