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This is VAERS ID 279176

Case Details

VAERS ID: 279176 (history)  
Form: Version 1.0  
Age: 36.0  
Gender: Female  
Location: Maryland  
Vaccinated:2006-08-11
Onset:2006-08-11
   Days after vaccination:0
Submitted: 2007-05-14
   Days after onset:276
Entered: 2007-05-17
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0702F / 1 UN / IM

Administered by: Private       Purchased by: Private
Symptoms: Arthralgia, Diarrhoea, Dizziness, Inappropriate schedule of drug administration, Influenza like illness, Insomnia, Myalgia, Nausea, Pyrexia, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: FLONASE; IBUPROFEN
Current Illness:
Preexisting Conditions: Drug hypersensitivity
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0704USA01468

Write-up: Information has been received from a nurse practitioner (NP), concerning a 37 year old female patient with drug hypersensitivity to BACITRACIN, NEOSPORIN who on 11-AUG-2006 at 2:15 pm was vaccinated with the first dose, 0.5ml, IM, of Gardasil (Lot #653650/0702F), and on 11-OCT-2006 at 5:39 pm with the second dose, 0.5ml, IM, of Gardasil (Lot #654540/0800F). Concomitant therapy included FLONASE and IBUPROFEN. The NP stated when the patient called to schedule her third dose of Gardasil, she reported that on 12-AUG-2006 following the first vaccination, she experienced dizziness and had "flu-like symptoms," including nausea, vomiting, diarrhea, arthralgia, myalgia, sleeplessness and fever (specified as "not above 100F"); she recovered on 17-AUG-2006. In addition, on 11-OCT-2006 following her second vaccination, the patient experienced identical events, and recovered on 16-OCT-2006. The NP stated she was "not sure that the patient should receive her third dose of the Gardasil." The patient sought unspecified medical attention. No further information is expected.


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