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This is VAERS ID 279204

Case Details

VAERS ID: 279204 (history)  
Form: Version 1.0  
Age: 25.0  
Gender: Female  
Location: New Jersey  
   Days after vaccination:0
Submitted: 2007-05-14
   Days after onset:45
Entered: 2007-05-17
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Incorrect route of drug administration, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Medication errors (narrow)

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? No
Previous Vaccinations:
Other Medications: None
Current Illness: Blood pressure high
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type: WAES0704USA0261

Write-up: Information has been received from a consumer, a 25 year old female patient with high blood pressure, who on 30-MAR-2007 was vaccinated orally with the first dose, 0.5ml, of Gardasil. There was no concomitant medication. On 31-MAR-2007 the patient reported that she had experienced tingling in her hands and feet after the vaccine was administered. At the time of this report, the patient had not recovered. The patient sought unspecified medical attention. Additional information has been requested. 6/25/07 Received office note from reporter which reveals patient called office on 4/16 to report having been seen in ER for complaints of body aches. Tx w/anti inflammatory meds & felling well now. Refused further HPV vaccine. FINAL DX: Adverse reaction to HPV vaccine.

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