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This is VAERS ID 279093

Case Details

VAERS ID: 279093 (history)  
Form: Version 1.0  
Age: 21.0  
Gender: Female  
Location: New York  
   Days after vaccination:4
Submitted: 2007-05-18
   Days after onset:16
Entered: 2007-05-21
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Computerised tomogram normal, Culture stool, Dizziness, Full blood count normal, Haematochezia, Headache, Nuclear magnetic resonance imaging normal, Vision blurred, Vomiting
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Haemorrhagic ovarian cyst; Irritable bowel syndrome; Distress gastrointestinal; Anxiety
Diagnostic Lab Data: head computed axial 05/06/07 - normal, magnetic resonance 05/06/07 - normal, complete blood cell 05/06/07 - normal, stool culture 05/06/07 - trace amount of blood
CDC Split Type: WAES0705USA02556

Write-up: Information has been received from a physician concerning a 21 year old female patient with 2.4 centimeter haemorrhagic ovarian cyst, possible irritable bowel syndrome, gastrointestinal symptoms and anxiety. On 28-APR-2007 she was vaccinated IM In the left arm deltoid with a first dose of Gardasil. 3 days post vaccination on 02-MAY-2007 the patient experienced headache, dizziness, blurred vision and "vomiting all the time." On 06-MAY-2007 the patient went to emergency room (ER) and was seen but not hospitalized. On 06-MAY-2007 patient was hospitalized with unknown diagnosis. All types of test were performed; head computed axial tomography (CT scan of the brain), complete blood cell count (CBC), magnetic resonance imaging (MRI) with normal results. Stool culture test was taken and there was a trace amount of blood. She was treated with intravenous (IV) fluids. On 09-MAY-2007 she was released from the hospital. She was still dizzy. The outcome was unknown. Additional information has been requested.

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