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This is VAERS ID 272304

Case Details

VAERS ID: 272304 (history)  
Age: 13.0  
Gender: Female  
Location: California  
Vaccinated:2006-11-10
Onset:2006-11-10
   Days after vaccination:0
Submitted: 2007-02-14
   Days after onset:96
Entered: 2007-02-15
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 0 - / IM

Administered by: Private       Purchased by: Private
Symptoms: Bronchospasm, Cough
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: albuterol, ZYRTEC, tetanus toxoid
Current Illness: Asthma, Allergic eczema
Preexisting Conditions:
Diagnostic Lab Data: UNK
CDC Split Type: WAES0701USA00990

Write-up: Information has been received from a registered nurse concerning a 13 year old female with asthma and allergic eczema who on 10-NOV-2006 at 12:00PM, was vaccinated in the right arm intramuscularly with a first 0.5 ml dose of Gardasil (yeast) (lot#653978/0955F). Concomitant suspect vaccination included a dose of tetanus toxoidon 10-NOV-2004. Other concomitant therapy included albuterol and ZYRTEC. There was no illness at the time of vaccination. On 10-Nov-2006 the patient experienced bronchospasm 20 minutes after receiving Gardasil (yeast). It was also reported that the patient developed a cough but she did not vomit. The patient used her albuterol inhaler and then rested and was recovered on the same day, 10-NOV-2006. No vomiting and no other anaphylaxis type reaction was noted. Additional information is not expected.


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