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This is VAERS ID 279047

Case Details

VAERS ID: 279047 (history)  
Form: Version 1.0  
Age: 24.0  
Gender: Female  
Location: Ohio  
   Days after vaccination:2
Submitted: 2007-05-14
   Days after onset:59
Entered: 2007-05-17
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Private       Purchased by: Other
Symptoms: Blood glucose increased
SMQs:, Hyperglycaemia/new onset diabetes mellitus (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: (therapy unspecified), LIPITOR, calcium (unspecified), HUMULIN, SYNTHROID, vitamins (unspecified)
Current Illness: Diabetes cellulitis juvenile onset; Penicillin allergy; Diabetes mellitus insulin-dependent; Drug hypersensitivity
Preexisting Conditions:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0704USA00522

Write-up: Initial and follow-up information has been received from a registered nurse concerning a 24 year old, female, receptionist, whose reported weight was 130 pounds and whose reported height was 62.5 inches with juvenile onset diabetes, insulin dependent diabetic with penicillin allergy and atropine allergy, who at 10:00 a.m. on 14-MAR-2007 was vaccinated into the right deltoid muscle with the first dose of Gardasil, (lot # 656049/0187U). Concomitant therapy included insulin human (Humulin), Synthroid, Lipitor, and calcium (unspecified), "zelnoim", vitamins (unspecified), "yazmin". It was reported that the patient had 4-5 days of increased blood sugars in the range of 500-600. This began 1 1/2 days, approximately on 16-MAR-2007, after receiving Gardasil. The patient''s blood sugars. "The patient did constant, intermittent blood sugars using a bolus of insulin to counteract". It was reported that it took several days to stablize the patient''s blood sugars. Additional information has been requested.

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