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This is VAERS ID 279516

Case Details

VAERS ID: 279516 (history)  
Age: 16.0  
Gender: Female  
Location: Ohio  
Vaccinated:2007-04-21
Onset:2007-04-21
   Days after vaccination:0
Submitted: 2007-05-14
   Days after onset:23
Entered: 2007-05-17
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 - / IM

Administered by: Private       Purchased by: Other
Symptoms: Asthma
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: albuterol, SINGULAIR
Current Illness: Asthma
Preexisting Conditions:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0704USA05060

Write-up: Initial and follow up information has been received from a Certified Registered Nurse Practitioner (CRNP) concerning a 16 year old female student with asthma who on 21-APR-2007 at 9:30 AM was vaccinated IM with a first dose of Gardasil (lot #0210U not valid). Concomitant therapy included montelukast sodium and albuterol over the counter (OTC)-10. On 21-APR-2007 at 5:00PM the patient developed exacerbation of asthma with activity during two basketball games one at 5:00PM and one at 8:00PM. She used albuterol 7 times during the basketball game. Normally she didn''t need to use the albuterol that many times. On 22-APR-2007 the patient recovered in the AM. Additional information is not expected.


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