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This is VAERS ID 279251

Case Details

VAERS ID: 279251 (history)  
Form: Version 1.0  
Age: 26.0  
Sex: Female  
Location: Unknown  
   Days after vaccination:240
Submitted: 2007-05-21
   Days after onset:10
Entered: 2007-05-22
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Abortion spontaneous, Blood human chorionic gonadotropin positive, Drug exposure during pregnancy, Inappropriate schedule of drug administration, Ultrasound abdomen
SMQs:, Tumour markers (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Termination of pregnancy and risk of abortion (narrow), Normal pregnancy conditions and outcomes (narrow), 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: Clonazepam, Topamax, Coumadin
Current Illness: Pregnancy NOS (LMP = Unknown); Drug hypersensitivity; Factor V Leiden mutation; 5-alpha reductase deficiency; Prothrombin level abnormal; Bipolar disorder; Convulsion
Preexisting Conditions: Pulmonary embolism; Deep vein thrombosis; Herpes virus infection
Diagnostic Lab Data: ultrasound 04/16/07 - + pregnancy confirmed, ultrasound 05/11/07 - positive miscarriage, beta-human chorionic 04/16/07 - + pregnancy confirmed
CDC Split Type: WAES0705USA02904

Write-up: Information has been received from a registered nurse for the pregnancy registry for Gardasil, concerning a 26 year old female with a drug reaction/allergy to Wellbutrin, factor v laiden mutation/clotting disorder, prothrombin mutation, bipolar disorder, seizure disorder and Mthfr and a history of pulmonary embolism and multiple deep vein thrombosis and herpes virus infection who on 13-SEP-2006 was vaccinated with her first Gardasil 0.5 ml IM (lot # 653735/0688F). Concomitant therapy included Coumadin, Topamax and clonazepam. The nurse stated that the patient was very non-complaint and never returned for the second or third dose of the vaccine. On 16-APR-2007, the patient was found to be pregnant which was confirmed by ultrasound and a pregnancy test. The patient''s last menstrual period, gestational age or due date were not reported. On 11-MAY-2007 the patient experienced spontaneous miscarriage which was confirmed by ultrasound. The patient sought unspecified medical attention. The patient was not hospitalized. Upon internal review, spontaneous miscarriage was determined to be an other important medical event. Additional information has been requested.

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