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This is VAERS ID 274397

Case Details

VAERS ID: 274397 (history)  
Form: Version 1.0  
Age: 23.0  
Gender: Female  
Location: Illinois  
   Days after vaccination:6
Submitted: 2007-03-19
   Days after onset:6
Entered: 2007-03-20
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0243U / 1 LA / -

Administered by: Private       Purchased by: Unknown
Symptoms: C-reactive protein normal, Full blood count normal, Unevaluable event

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:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: CBC, CRP normal
CDC Split Type:

Write-up: None Stated 04/02/07-records received from facility. Developed rash around injection site, pulse 100, felt shaky, tightness in chest and heart felt like it was racing. Feels anxious, agitated, lightheaded. PE:WNL. DX: Anxiety disorder.

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