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This is VAERS ID 274736

(NOTE: This result is from the 2/14/2018 version of the VAERS database)

Case Details

VAERS ID: 274736 (history)  
Form: Version 1.0  
Age: 26.0  
Sex: Female  
Location: California  
   Days after vaccination:0
Submitted: 2007-03-14
   Days after onset:85
Entered: 2007-03-16
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Abdominal pain, Back pain, Chills, Dizziness, Injection site pain, Nausea, Pruritus, Pyrexia
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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: vitamins (unspecified)
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type: WAES0703USA00109

Write-up: This is in follow-up to report (s) previously submitted on 3/14/2007. Information has been received from a nurse practitioner concerning a 26 year old female with no pertinent medical history who on 18-DEC-2006 was vaccinated intramuscularly, into the left deltoid with a first 0.5 ml dose of Gardasil (lot # "0604F"). Concomitant therapy included vitamins (unspecified). On 18-DEC-2006 the patient experienced soreness at the injection site, sacral back pain, mild low abdominal cramping, nausea, generalized itchiness, mild dizziness and "felt feverish with chills." Unspecified medical attention was sought. There were no laboratory or diagnostic tests performed. The patient recovered in 1 week without treatment. Additional information has been requested.

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