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This is VAERS ID 279096

Case Details

VAERS ID: 279096 (history)  
Form: Version 1.0  
Age: 16.0  
Gender: Female  
Location: Unknown  
Vaccinated:2007-05-01
Onset:2007-05-01
   Days after vaccination:0
Submitted: 2007-05-18
   Days after onset:17
Entered: 2007-05-21
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK UN / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Cardiomyopathy, Intensive care, Intubation, Pneumonia
SMQs:, Angioedema (broad), Cardiomyopathy (narrow), Eosinophilic pneumonia (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown Records received 6/27/07-PMX: Bronchitis.
Allergies:
Diagnostic Lab Data: Unknown; Records received 6/27/07-Abnormal pap smear. Echo Doppler. No evidence of inter-atrial septal shunt. Mild regurgitation of pulmonic valve. Global hypokinesis of left ventrilce worse along the anterior septal walls. MV inflow pattern consistent with abnormal relaxation and diastolic dysfunction. Focal thickening of mitral valve. CXR bilateral pneumonia. ABG pO2 66 while on Oxygen.
CDC Split Type: WAES0705USA03117

Write-up: Information has been received from a physician concerning a 17 year old female who in approximately May 2007 was vaccinated with Gardasil. The physician reported that the patient was rushed to the hospital the day following vaccination with Gardasil. The patient was admitted to the intensive care unit and was still there as of 16-MAY-2007. The patient was diagnosed with cardiomyopathy and pneumonia, which required ICU management and intubation. The physician considered the cardiomyopathy and pneumonia to be life-threatening and other important medical events. Additional information has been requested. 6/27/07-records received from facility for DOS 5/9-5/17/07-DC DX: Acute respiratory syndrome. Disseminated intravascular coagulation. Diastolic dysfunction. Seen in PCP office for shortness of breath and chest pain. Three days prior to admission began to experience tactile fevers and headaches. Became short of breath day she received Gardasil vaccine. Including midsternal chest pain and productive cough. Complaints on admission vomiting and palpitations. Temp 99.9. HR 117. Respirations 60.


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