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This is VAERS ID 276907

Case Details

VAERS ID: 276907 (history)  
Form: Version 1.0  
Age: 14.0  
Gender: Female  
Location: Unknown  
Vaccinated:2007-03-27
Onset:2007-03-27
   Days after vaccination:0
Submitted: 2007-04-13
   Days after onset:17
Entered: 2007-04-16
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Abdominal pain upper
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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: Unk
Current Illness:
Preexisting Conditions: Penicillin allergy
Allergies:
Diagnostic Lab Data: None
CDC Split Type: WAES0703USA05033

Write-up: Information has been received from a consumer concerning her 14 year old female with penicillin allergy who on 27-MAR-2007 was vaccinated with 0.5 mL of Gardasil. On 27-MAR-2007 the patient experienced severe stomach pain. The patient''s severe stomach pain persisted. Additional information has been requested.


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