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This is VAERS ID 276859

Case Details

VAERS ID: 276859 (history)  
Form: Version 1.0  
Age: 17.0  
Gender: Female  
Location: Pennsylvania  
Vaccinated:2006-12-01
Onset:2006-12-01
   Days after vaccination:0
Submitted: 2007-04-13
   Days after onset:132
Entered: 2007-04-16
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 - / -

Administered by: Other       Purchased by: Other
Symptoms: Bronchial disorder, Chest X-ray, Dizziness, Dyspnoea, Headache, Inflammation, Laboratory test, Nausea, Respiratory distress, Vertigo
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (narrow), Hypersensitivity (broad), Respiratory failure (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? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Chest x-ray 12/06; diagnostic laboratory 12/06
CDC Split Type: WAES0703USA04151

Write-up: Information has been received from a consumer (an office manager), via a company representative, concerning the consumer''s 17 year old daughter, who in December 2006, was vaccinated with the first dose, 0.5ml, of Gardasil vaccine (yeast), and vaccinated with the second dose of Gardasil vaccine (yeast) (date not specified). In December 2006, three days after the first vaccination, the consumer reported her daughter experienced "dizziness, lightheadedness, vertigo, difficulty breathing, respiratory distress and bronchial inflammation." The consumer reported her daughter was taken to the ER, but she was not admitted. She added that a chest x-ray and "bloodwork" were performed (results not provided). In addition, she added that after her daughter experienced nausea, headache, and dizziness after the second vaccination was administered (dates not specified). At the time of the report, it was unknown if the patient had recovered. Additional information is not expected.


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