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This is VAERS ID 276863

Case Details

VAERS ID: 276863 (history)  
Form: Version 1.0  
Gender: Female  
Location: Ohio  
   Days after vaccination:3
Submitted: 2007-04-13
   Days after onset:26
Entered: 2007-04-16
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Body temperature increased, Epstein-Barr virus antibody negative, Influenza serology negative, Laboratory test normal, Metabolic function test, Mononucleosis heterophile test negative, Pyrexia, Streptococcus identification test negative, Urine analysis
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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: None
Current Illness:
Preexisting Conditions: Sulfonamide allergy; Penicillin allergy
Diagnostic Lab Data: diagnostic laboratory; 03/18/07; negative diagnostic laboratory; 03/18/07; negative Streptococcus oralis; 03/18/07; negative serum Epstein-Barr; 03/18/07; negative'' temperature measurement; 03/18/07; 104 degrees
CDC Split Type: WAES0703USA04164

Write-up: Information has been received from a registered nurse, via a company representative, concerning a female patient (age with allergies to sulfonamide and penicillin, who on 15-MAR-2007 was vaccinated with a dose, 0.5 ml, IM, of Gardasil. There was no concomitant medication. On approximately 18-MAR-2007 ("three days" later) the patient developed a fever of 104F, and visited the emergency room. Diagnostic labs were as follows: complete metabolic panel (CMP), urinalysis, "mono, strep and influenza" screenings, all with negative results. Subsequently, the patient recovered from the fever. Additional information is not expected.

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