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This is VAERS ID 270965

Case Details

VAERS ID: 270965 (history)  
Form: Version 1.0  
Age: 19.0  
Sex: Female  
Location: New York  
   Days after vaccination:0
Submitted: 2007-01-22
   Days after onset:18
Entered: 2007-01-23
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0962F / 1 UN / -

Administered by: Other       Purchased by: Other
Symptoms: Body temperature increased, Dyspnoea, Influenza, Pain
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad)

Life Threatening? No
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: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC Split Type: WAES0701USA02133

Write-up: Information has been received from a registered nurse concerning a 19 year old female who on 04-JAN-2007 was vaccinated with a first dose of Gardasil (yeast) (0.5 ml) (lot # 654510/0962F). Subsequently, on 04-JAN-2007, the patient was rushed to the emergency room with symptoms of body aches, breathing problems and a temperature of 103. The patient was released from the emergency room within 12 hours. The nurse reported that the emergency room physician believed that the above reaction was due to influenza. The patient recovered. The reporter considered the patient''s experience to be disabling. Additional information has been requested.

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