National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 271107

Case Details

VAERS ID: 271107 (history)  
Form: Version 1.0  
Age: 18.0  
Gender: Female  
Location: Illinois  
Vaccinated:2006-10-26
Onset:2006-10-31
   Days after vaccination:5
Submitted: 2007-04-06
   Days after onset:156
Entered: 2007-01-22
   Days after submission:73
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0800F / 2 UN / UN

Administered by: Private       Purchased by: Private
Symptoms: Epstein-Barr virus test positive, Infectious mononucleosis
SMQs:

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: NONE
Current Illness: Asthma, penicillin allergy, Sulfonamide allergy
Preexisting Conditions: Infectious mononucleosis
Allergies:
Diagnostic Lab Data: serum Epstein-Barr virus 10/31/06 - positive
CDC Split Type: WAES0612USA02256

Write-up: Information has been received from a registered nurse concerning an 18 year old female patient with asthma, penicillin allergy, sulfonamide allergy and a history of infectious mononucleosis in December 2005, who on 21-Oct-2006 was vaccinated with the second dose of Gardasil vaccine (yeast) (lot# 654540/0800F). There was no concomitant medication. It was reported by the patient''s mother that one week following vaccination, on approximately 28-Oct-2006 the patient developed mononucleosis which had been confirmed by a blood test taken at the university the patient attended. Unspecified medical attention was sought, however the patient received no treatment. At the time of this report the patient had not yet recovered. Additional information has been requested. This is in follow-up to report (s) previously submitted on 1/16/2007. Information has been received from a registered nurse concerning an 18 year old female student with asthma, penicillin allergy, sulfonamide allergy and a history of infectious mononucleosis in December 2005, who on 26-OCT-2006 was vaccinated in the left arm with the second dose of GARDASIL (lot #654540/0800F). There was no concomitant medication and no illnessess at the time of vaccination. It was reported that on 31-OCT-2006 the patient tested positive for mononucleosis at the university she attended. Unspecified medical attention was sought, however the patient received no treatment. At the time of this report, the outcome of the event was unknown. No further information is expected.


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=271107


Copyright © 2017 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166