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This is VAERS ID 276120

Case Details

VAERS ID: 276120 (history)  
Form: Version 1.0  
Age: 27.0  
Gender: Female  
Location: California  
   Days after vaccination:0
Submitted: 2007-04-06
   Days after onset:37
Entered: 2007-04-09
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / 2 - / IM

Administered by: Other       Purchased by: Other
Symptoms: Bone pain, Chills, Dyspnoea, Inappropriate schedule of drug administration, Lethargy, Myalgia, Rash
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Osteonecrosis (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (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: Unknown
Current Illness:
Preexisting Conditions: Thrombosis leg; Loop electrosurgical excision procedure; Dysplasia; Pregnancy
Diagnostic Lab Data:
CDC Split Type: WAES0703USA00380

Write-up: Information has been received from a physician concerning a 27 year old female with no known drug allergies and a history of a left thrombosis (2001), loop electrosurgical excision procedure for mild dysplasia (06-DEC-2006) and a pregnancy (2001) who was vaccinated intramuscularly on 27-NOV-2006 with the first dose of Gardasil (Lot # not provided). On 27-FEB-2007 the patient was vaccinated intramuscularly in the right deltoid with the second dose of Gardasil (Lot # 654702/0011U). Five to eight hours post vaccination the patient developed a rash on right shoulder that spread up to her neck, myalgia, lethargy, chills, bone aching and mild shortness of breath. It was reported that 48 hours later, the patient returned to her physicians office who recommended treatment with Benadryl. The physician reported that the patient did not take the Benadryl. It was reported that the rash as resolving and the patient. The physician reported that the patient was seen again in his office on 01-MAR-2007 and was still experiencing lethargy and bone pain. The physician also reported that the patient did not have any adverse effects after that the first of Gardasil. He states that he was unsure if the third dose of Gardasil will be administered. Additional information has been rechecked.

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