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This is VAERS ID 272509

Case Details

VAERS ID: 272509 (history)  
Form: Version 1.0  
Age: 18.0  
Gender: Female  
Location: New York  
Vaccinated:2007-01-16
Onset:0000-00-00
Submitted: 2007-02-14
Entered: 2007-02-15
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 LA / IM

Administered by: Other       Purchased by: Other
Symptoms: Abdominal pain, Chest pain, Dyspnoea, Epigastric discomfort, Respiratory disorder, Smear cervix
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Respiratory failure (broad)

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: PEPCID; (therapy unspecified)
Current Illness: Penicillin allergy; Rash; Fever; Nulliparous; Smoker; Acne; Overweight
Preexisting Conditions: Appendectomy
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type: WAES0701USA03962

Write-up: Information has been received from the father of an 18 year old female with a penicillin allergy noted as rash and fever. On 16-JAN-2007, the patient was vaccinated intramuscularly in the deltoid, with the first dose of Gardasil (yeast). There were no concomitant medications reported. On 18-JAN-2007, the patient developed epigastric pressure and discomfort. On 19-JAN-2007, the patient was examined by her physician and was prescribed famotidine. On 21-JAN-2007, the patient complained of difficulty and discomfort breathing which worsened on 22-JAN-2007. On 23-JAN-2007, the patient was planning to seek medical attention, at her local school infirmary. At the time of this report, the patient had not recovered from the events. Additional information has been requested. 07/06/07 This is in follow-up to report(s) previously submitted on 2/14/2007. Information has been received from a physician concerning an overweight 18 year old female with a penicillin allergy noted as rash and fever, acne, smoking, a history of an appendectomy and a family history of the mother (age 45) with ovarian cancer (currently undergoing chemotherapy). On 16-JAN-2007, at 6:32 P.M., the patient was vaccinated intramuscularly in the left deltoid, with the first dose 0.5 ml of GARDASIL. Concomitant therapy included topical medications for acne. On the 16-JAN-2007 the patient had a Pap test done with reflex HPV. On 17-JAN-2007 (previously reported as 18-JAN-2007) the patient complained of a week history of a band of abdominal pain across her abdomen which was associated with chest pain. She denied any burning or back wash of food or fluid coming up in her chest, although occasionally she had this chest pain. There were no foods that aggravated her and she followed a healthy diet. The patient had normal bowel movements and her last period was 2 weeks prior. On examination, the patient was in no acute distress; her abdomen was soft, non-tender, nondistended; no hepatosplenomegaly or masses. The physician''s impression was abdominal pain/possible mild viral gastritis. The patient was prescribed famotidine (MSD) 20 mg, twice a day. She was to avoid caffeine and acidic foods or large meals before bed. On 21-JAN-2007, the patient complained of difficulty and discomfort breathing which worsened on 22-JAN-2007. On 23-JAN-2007, the patient was planning to seek medical attention, at her local school infirmary. At the time of this report, the patient had not recovered from the events. Additional information is not expected.


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