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This is VAERS ID 276910

Case Details

VAERS ID: 276910 (history)  
Form: Version 1.0  
Age: 22.0  
Gender: Female  
Location: Michigan  
   Days after vaccination:1
Submitted: 2007-04-13
   Days after onset:79
Entered: 2007-04-16
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Unknown       Purchased by: Unknown
Symptoms: Body temperature increased, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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: SEASONALE
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: body tem, 01/22/07, 103F
CDC Split Type: WAES0703USA05095

Write-up: Information has been received from a registered nurse concerning a 22 year old female who on 22-JAN-2007 was vaccinated with 0.5mL IM, first dose, Gardasil (lot# 655165/1425F). Concomitant therapy included Seasonale. On 23-JAN-2007 the patient experienced fever of 103F and nausea. The patient sought unspecified medical attention and did not require lab diagnostic studies to be performed. Subsequently, the patient recovered from fever of 103F and nausea after the injection x 2 days. The patient also experienced nausea (was nauseated). The patient sought unspecified medical attention and did not require lab diagnositc studies to be performed. Subsquently, the patient recovered completely. Additional information has been requested. This is in follow-up to report (s) previously submitted on 4/13/2007. Additional attempts to contact the patient had been unsuccessful sin 27-Mar-2007 when she reported the reaction. At the time of this report, the patient had not returned for ther second GARDASIL. No product quality comlaint was involved. No further information is available.

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