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This is VAERS ID 274217

Case Details

VAERS ID: 274217 (history)  
Form: Version 1.0  
Age: 11.0  
Gender: Female  
Location: Montana  
Vaccinated:2006-12-15
Onset:2007-01-11
   Days after vaccination:27
Submitted: 2007-03-14
   Days after onset:61
Entered: 2007-03-16
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 - / IM

Administered by: Other       Purchased by: Other
Symptoms: Asthma exercise induced
SMQs:, Asthma/bronchospasm (narrow)

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: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type: WAES0702USA02397

Write-up: Information has been received from a certified medical assistant concerning her 11 year old daughter with no past medical history and no allergies who on 15-DEC-2006 was vaccinated with a first dose of Gardasil (yeast), IM. There was no concomitant medication. On 11-JAN-2007 the patient experienced excerise induced asthma. The patient noticed that she was short of breath during exercise during sports. The patient had recovered without treatment on 30-JAN-2007. There were no relevant diagnostic tests or laboratory data. Additional information has been requested.


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