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This is VAERS ID 271145

(NOTE: This result is from the 12/8/2009 version of the VAERS database)

Case Details

VAERS ID: 271145 (history)  
Form: Version .0  
Age: 21.0  
Gender: Female  
Location: Maryland  
Vaccinated:2006-12-19
Onset:2006-12-19
   Days after vaccination:0
Submitted: 2007-01-16
   Days after onset:28
Entered: 2007-01-22
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0954F / 0 - / IM

Administered by: Other       Purchased by: Other
Symptoms: Flushing, Hypotension, Malaise
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Desogen, Allegra, Motrin, Zantac
Current Illness:
Preexisting Conditions: hypersensitivity
Allergies:
Diagnostic Lab Data: blood pressure, 12/19/06, 101/6 mmHg
CDC Split Type: WAES0612USA03566

Write-up: Information has been received from a licensed practical nurse concerning a 20 year old female who had hypersensitivity reported as "Motrin for allergies". On 19 Dec 2006, the patient was vaccinated intramuscularly with the firs "single dose vial" of Gardasil (Lot # 653938/0954F). Concomitant therapy included Motrin, Desogen, Allegra and Zantac. On 19 Dec 2006, "almost immediately after vaccination", the patient became a little flushed in the face and had to take a minute to sit and gather herself together. The patient was noted to have a blood pressure of 101/65 mmHg (date unknown). The patient sought unspecified medical attention. It was reported that the patient" improved within seconds". On 19 Dec 2006, the patient had recovered from the event. The licensed practical nurse reported that they were planning to vaccinate for the second and third dose as indicated in the "PI". Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20091208&IDNUMBER=271145


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