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This is VAERS ID 272303

Case Details

VAERS ID: 272303 (history)  
Form: Version 1.0  
Age: 15.0  
Gender: Female  
Location: Unknown  
   Days after vaccination:16
Submitted: 2007-02-14
   Days after onset:101
Entered: 2007-02-15
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0588F / 1 - / IM

Administered by: Private       Purchased by: Other
Symptoms: Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (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: amoxicillin
Current Illness: Pharynigitis, Rhinitis allergic
Preexisting Conditions:
Diagnostic Lab Data: UNK
CDC Split Type: WAES0701USA00975

Write-up: Information has been received from a physician concerning a 15 year old female patient with allergic rhinitis who on 20-OCT-2006 was vaccinated intramuscularly in the morning with a first dose of Gardasil (yeast) (lot#653735/0688F). Illness at the time of vaccination included pharynigitis. Concomitant therapy included amoxicillin. In the evening of 05-NOV-2006, three weeks after vaccination, the patient developed shortness of breath. The patient had no history of asthma. Subsequently, on an unspecified date, the patient recovered. Additional information is not expected.

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