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This is VAERS ID 274360

Case Details

VAERS ID: 274360 (history)  
Form: Version 1.0  
Sex: Female  
Location: Florida  
Submitted: 2007-03-19
Entered: 2007-03-20
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / -

Administered by: Other       Purchased by: Other
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), 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? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC Split Type: WAES0703USA01318

Write-up: Initial and follow up information has been received from a Licensed Practical nurse and a physician concerning a female patient who was vaccinated with a first dose of Gardasil. She developed hives within 2-3 hours of receiving the injection. Unspecified medical attention was sought. The patient was not recovered. The nurse considered hives to be disabling she was not available for follow up, and when the physician was contacted, he could not provide any information regarding why the nurse considered the event disabling. He had not been able to contact the patient. He had no further information regarding her outcome. Additional information has been requested.

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