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This is VAERS ID 264750

Case Details

VAERS ID: 264750 (history)  
Form: Version 1.0  
Age: 28.0  
Gender: Female  
Location: New York  
Vaccinated:2006-09-18
Onset:2006-09-18
   Days after vaccination:0
Submitted: 2006-10-13
   Days after onset:25
Entered: 2006-10-17
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0637F / 2 LA / IM

Administered by: Private       Purchased by: Private
Symptoms: Abdominal pain lower, Dizziness, Fatigue, Headache, Nausea, Ultrasound pelvis
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: (therapy unspecified), LEXAPRO, FLOVENT, lorazepam, AMBIEN
Current Illness: Epilepsy; Asthma; Drug hypersensitivity; Convulsion disorder
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Pelvic ultrasound, R/O ovarian cyst
CDC Split Type: WAES0609USA04248

Write-up: Information has been received from a 28 year old female patient with epilepsy, asthma and an allergy to carbamazepine (TEGRETOL) who on 18-SEP-2006 was vaccinated with a dose of HPV rL1 6 11 16 18 VLP vaccine (yeast). Concomitant therapy included escitalopram oxalate (LEXAPRO), lorazepam, "lomectol," zolpidem tartrate (AMBIEN), and fluticasone propionate (FLOVENT). The patient stated that since her vaccination she has been experiencing dizzy, tired, has headaches and felt nauseous. No medical attention was sought. As of the report date the patient has not recovered. Additional information has been requested. 01/05/2007 Follow up information has been received from a physician concerning the patient with a seizure disorder who on 18-SEP-2006 at 9:50 a.m. received her second dose of GARDASIL, lot # 653937/0637F, in the left deltoid. The physician reported that the patient complained of right lower quadrant pain and mild nausea after receiving the vaccine. A pelvic sonogram was performed to rule out ovarian cyst. The patient had not yet recovered. Additional information is not expected.


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