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This is VAERS ID 279037

Case Details

VAERS ID: 279037 (history)  
Age: 23.0  
Gender: Female  
Location: Indiana  
Vaccinated:2007-04-02
Onset:2007-04-02
   Days after vaccination:0
Submitted: 2007-05-14
   Days after onset:42
Entered: 2007-05-17
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 - / IM

Administered by: Other       Purchased by: Other
Symptoms: Dyspnoea, Nausea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: hormonal contraceptives
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type: WAES0704USA00315

Write-up: Information has been received from a medical assistant concerning a 23 year old female with no pertinent medical history who on approximately 02-FEB-2007 was vaccinated with a first dose of Gardasil. On 02-APR-2007, the patient was vaccinated, intramuscularly, with a second dose of Gardasil. Concomitant therapy included hormonal contraceptives (unspecified). On 02-APR-2007, within a few hours of the vaccination, the patient experienced shortness of breath and nausea. She called the physician''s office and the physician prescribed Benadryl. There were no laboratory or diagnostic tests performed. The patient''s outcome was unknown. Additional information has been requested.


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