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This is VAERS ID 272579

Case Details

VAERS ID: 272579 (history)  
Form: Version 1.0  
Age: 20.0  
Gender: Female  
Location: Washington  
Vaccinated:2006-11-29
Onset:2006-11-29
   Days after vaccination:0
Submitted: 2007-04-06
   Days after onset:127
Entered: 2007-02-15
   Days after submission:49
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 654540/0800F / 1 UN / IM

Administered by: Private       Purchased by: Private
Symptoms: Dizziness, Headache, Pharyngeal hypoaesthesia, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Hypersensitivity (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ortho Evra
Current Illness: Drug hypersensitivity
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC Split Type: WAES0701USA04623

Write-up: Information has been received from a registered nurse concerning a 20 year old female with an allergy to amoxicillin (AUGMENTIN) who on 29-NOV-2006 was vaccinated IM, into the deltoid, with a first dose of HPV VLP vaccine (yeast) (lot # 654540/0800F). Concomitant therapy included ORTHO EVRA. Approximately 1 minute after the vaccination, the patient reported that her "throat felt constricted." Subsequently, the patient recovered after 5 minutes. On 25-JAN-2007 the patient was vaccinated with a second dose of dose of HPV VLP vaccine (yeast). Five seconds after the vaccination, the patient experienced "numbness in the throat" that lasted a short duration. The patient reported that she developed an intense headache 30 minutes after the vaccination that lasted until she went to bed. On 26-JAN-2007, the patient recovered from the headache. Unspecified medical attention was sought. There were no laboratory or diagnostic tests performed. Additional information has been requested. This is in follow-up to report (s) previously submitted on 2/14/2007. Initial and follow-up information has been received from a registered nurse concerning a 20 year old female with an allergy to AUGMENTIN who on 29-NOV-2006 was vaccinated intramucularly, into the deltoid, with a first dose of GARDASIL (lot # 654540/0800F). Concomitant therapy included ORTHO EVRA. Within 1 minute after the vaccination, the patient felt "tightness in throat" and lightheadedness. Subsequently, the patient recovered after 5 minutes. On 25-JAN-2007 the patient was vaccinated, intramuscularly with a second dose of GARDASIL (lot #654540/0800F). As the vaccine was administered the patient experienced "momentary numbness at the throat area of neck" that lasted a few seconds. Twenty minutes after the vaccination, while the patient was on the road, she called the physician''s office to report she had developed an intense frontal headache. There were no visual problems and it was not interrupting her ability to function. The headache that lasted until she went to bed. On 26-JAN-2007, the patient recovered from the headache. There were no laboratory or diagnostic tests performed. Additional information is not expected.


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