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This is VAERS ID 277393

Case Details

VAERS ID: 277393 (history)  
Form: Version 1.0  
Age: 18.0  
Gender: Female  
Location: Pennsylvania  
Vaccinated:2007-04-23
Onset:2007-04-24
   Days after vaccination:1
Submitted: 2007-04-24
   Days after onset:0
Entered: 2007-04-25
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0188U / 2 LA / -

Administered by: Private       Purchased by: Private
Symptoms: Dyspnoea, Injection site pruritus, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (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: None
Current Illness: None
Preexisting Conditions: Seasonal allergies
Allergies:
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Pt''s school nurse called pt c/o SOB at school. Also c/o itching and Welt at site of 2nd Gardasil injection site. Advised to send pt to closest ER for evaluation.


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