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This is VAERS ID 279069

Case Details

VAERS ID: 279069 (history)  
Age: 20.0  
Gender: Female  
Location: Minnesota  
Vaccinated:2007-03-08
Onset:2007-03-08
   Days after vaccination:0
Submitted: 2007-05-14
   Days after onset:66
Entered: 2007-05-17
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Chills, Condition aggravated, Hyperhidrosis, Pyrexia, Rash, Tremor, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: ZYRTEC; TRINESSA; SINGULAR
Current Illness: Asthma; allergic reaction to antibiotics
Preexisting Conditions:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0704USA00928

Write-up: This is in follow-up to report (s) previously submitted on 5/14/2007. Information has been received from a Registered Nurse (R.N.) concerning a 12 year old female patient who on 08-MAR-2007 was vaccinated with a second dose of Gardasil. Patient had a rash before getting the vaccination. On 08-MAR-2007 the patient''s rash (on her chest and neck) became worse and she was shaking, had fever and sweating. Unspecified medical attention was sought. The patient recovered. Additional information has been requested. Initial and follow up information has been received from a Registered Nurse (R.N.) concerning a 20 year old (previously mentioned as 12 year old) female student with asthma and rash, hives to amoxicillin(+) clavulante potassium who on 08-MAR-2007 was vaccinated IM in left deltoid with a second dose of GARDASIL. Concomitant therapy included TRINESSA., montelukast sodium (MSD) and ZYRTEC. Patient had a rash before getting the vaccination. On 08-MAR-2077 the patient''s rash ( on her chest and neck) became worse and she was shaking, had fever and sweating. Unspecified medical attention was sought. In follow up it was reported that on 09-MAR-2007 patient woke up at 01:00AM shaking shivering for 1 1/4 hour. At 4:30AM she broke out sweating with fever. On 11-MAR-2007 patient''s mother reported that she recovered. Additional information is not expected.


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