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This is VAERS ID 276806

Case Details

VAERS ID: 276806 (history)  
Form: Version 1.0  
Age: 49.0  
Gender: Female  
Location: Arizona  
   Days after vaccination:0
Submitted: 2007-04-13
   Days after onset:29
Entered: 2007-04-16
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Hypoventilation, Inappropriate schedule of drug administration, Somnolence
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Respiratory failure (narrow), Medication errors (narrow), Hypoglycaemia (broad), Infective pneumonia (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: SYNTHROID; VALTREX; vitamin b (unspecified)
Current Illness:
Preexisting Conditions: Penicillin allergy; Sulfonamide allergy; Drug hypersensitivity; Hypothyroidism
Diagnostic Lab Data:
CDC Split Type: WAES0703USA03468

Write-up: Information has been received from a registered nurse concerning a 49 year old female with penicillin allergy, sulfa allergy, ciprofloxacin hydrochloride (Cipro) allergy, erythromycin (E-Mycin) allergy and hypothyroidism who on 15-MAR-2007 was vaccinated with Gardasil, IM. Concomitant therapy included Levaothyroxine Na (SYNTHROID), vitamin B (unspecified) and valacyclovir HC1 (VALTREX). On 15-MAR-2007, after receiving the first dose of Gardasil, the patient became drowsy and had trouble taking a deep breath. The patient was not in distress. No treatment was provided. The patient called the physician back on 16-MAR-2007 and reported she was still having trouble taking a deep breath. Additional information has been requested.

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