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This is VAERS ID 276821

Case Details

VAERS ID: 276821 (history)  
Form: Version 1.0  
Age: 14.0  
Gender: Female  
Location: Unknown  
   Days after vaccination:1
Submitted: 2007-04-13
   Days after onset:31
Entered: 2007-04-16
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Unknown       Purchased by: Unknown
Symptoms: Diarrhoea, Fatigue, Rash, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0703USA03712

Write-up: Information has been received from a health professional concerning a 14 year old female who on 12-MAR-2007 was vaccinated with Gardasil (Lot 653736/0014U). On 13-MAR-2007 the patient experienced a rash on her chest, back and face. On 14-MAR-2007, the patient experienced fatigue. On that same day, the patient went to see her pediatrician who placed her on therapy with hydrocortisone (manufacturer unknown) and BENADRYL. The patient did not improve and hydrocortisone and felt to be ineffective (WAES#0703USA04721). On 16-MAR-2007, the patient experienced vomiting and diarrhea. The patient''s rash, fatigue, vomiting and diarrhea persisted. Additional information has been requested.

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