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This is VAERS ID 278789

Case Details

VAERS ID: 278789 (history)  
Form: Version 1.0  
Age: 24.0  
Sex: Female  
Location: Unknown  
   Days after vaccination:0
Submitted: 2007-05-16
   Days after onset:12
Entered: 2007-05-17
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Dysphagia, Dyspnoea, Incorrect route of drug administration, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (broad), Medication errors (narrow)

Life Threatening? Yes
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: cholestyramine resin, NUVARING, PRILOSEC, probiotics (unspecified), vitamins (unspecified) tablet
Current Illness: Gastrooesophageal reflux disease; Drug hypersensitivity
Preexisting Conditions: Anaphylactic reaction
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0705USA02132

Write-up: Information has been received from a registered nurse concerning a 24 year old female with gastrooesophageal reflux disease and a history of anaphylactic reaction while on therapy with VICODIN who on 04-MAR-2007 was vaccinated subcutaneously with a 0.5 mL dose of Gardasil (lot 657622/0388U). Concomitant therapy included NUVARING, PRILOSEC, cholestyramine resin, vitamins (unspecified) and probiotics "PB8". The patient left the office after receiving the dose of Gardasil. Within 15 minutes, the patient started to have shortness of breath, difficulty swallowing, and a feeling of her throat tightening. The patient was never unconscious and had no other symptoms. The patient went to the emergency room where she received possibly prednisone, BENADRYL, and TAGAMET IV. The patient was discharged to home after 4 hours. Subsequently, the patient recovered and was not receiving further treatment for the event. Shortness of breath, difficulty swallowing and throat tightness were considered to be immediately life-threatening by the reporter. Additional information has been requested.

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