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This is VAERS ID 276929

Case Details

VAERS ID: 276929 (history)  
Form: Version 1.0  
Gender: Female  
Location: Illinois  
Submitted: 2007-04-13
Entered: 2007-04-16
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Dysplasia
SMQs:, Premalignant disorders, general conditions and other site specific disorders (narrow)

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: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0703USA05419

Write-up: Information has been received from a physician concerning a female who was vaccinated with Gardasil vaccine (yeast) (dose and date not provided) as part of a clinical trial she was involved with. Subsequently "the physician reported that the patient had received the Gardasil vaccine (yeast) in the trial and was experiencing "dysplasia syn 2 due to one of the strains of the HPV virus, either 16 or 18." No lot number was provided. The patient sought unspecified medical attention. Additional information has been requested.

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