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This is VAERS ID 279096

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 279096
Age:16.0
Gender:Female
Location:Unknown
Vaccinated:2007-05-01
Onset:2007-05-01
Submitted:2007-05-18
Entered:2007-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Acute respiratory distress syndrome, Cardiomyopathy, Chest pain, Chest X-ray abnormal, Diastolic dysfunction

Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, days: 8     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type':

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


Changed on 12/8/2009

VAERS ID: 279096 Before After
Age:16.0
Gender:Female
Location:Unknown
Vaccinated:2007-05-01
Onset:2007-05-01
Submitted:2007-05-18
Entered:2007-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - - UN / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Acute respiratory distress syndrome, Cardiomyopathy, Chest pain, Chest X-ray abnormal, Disseminated intravascular coagulation, Dyspnoea, Headache, Intensive care, Intubation, Pneumonia, Productive cough, Pyrexia, Diastolic dysfunction, Echocardiogram abnormal

Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No No
ER or Doctor Visit? No
Hospitalized? Yes, days: 8     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown Records received 6/27/07-PMX: Bronchitis.
Diagnostic Lab Data: Unknown 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 patter
CDC 'Split Type': (blank) 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 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.


Changed on 2/14/2017

VAERS ID: 279096 Before After
Age:16.0
Gender:Female
Location:Unknown
Vaccinated:2007-05-01
Onset:2007-05-01
Submitted:2007-05-18
Entered:2007-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Acute respiratory distress syndrome, Cardiomyopathy, Chest pain, Chest X-ray abnormal, Disseminated intravascular coagulation, Dyspnoea, Headache, Intensive care, Intubation, Pneumonia, Productive cough, Pyrexia, Diastolic dysfunction, Echocardiogram abnormal

Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, days: 8     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown Records received 6/27/07-PMX: Bronchitis.
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 patter 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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