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This is VAERS ID 279518

Case Details

VAERS ID: 279518 (history)  
Form: Version 1.0  
Age: 33.0  
Gender: Female  
Location: Illinois  
Vaccinated:2006-09-09
Onset:2006-09-09
   Days after vaccination:0
Submitted: 2007-05-14
   Days after onset:247
Entered: 2007-05-17
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0263U / 3 - / IM

Administered by: Other       Purchased by: Other
Symptoms: Hypoaesthesia, Inappropriate schedule of drug administration, Medication error, Nuclear magnetic resonance imaging, Paraesthesia, Vaccine positive rechallenge
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: LOESTRIN, DETROL LA
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: MAGNETIC RESONANCE - Negative records received 7/12/07-CRP and ESR negative.MRI lumbo sacral spine Small diffuse bulge at L4-5. MRI thoracic spine. Minimal degenerative disc disease within thoracic spine.MRI cervical spine. Minimal cervical degenerative disc disease without significant thecal sac or nueral foraminal stenosis.
CDC Split Type: WAES0704USA04497

Write-up: Information has been received from a nurse, via a company representative, concerning a 34 year old female patient, who on 09-SEP-2006 was vaccinated with the first dose, 0.5ml, of Gardasil (Lot #653937/0637F). Concomitant therapy included Loestrin and Detrol LA. The nurse reported that after the vaccine was administered (date unspecified), the patient "experienced tingling and numbness in most areas of her body." On an unspecified date, the patient received her second dose, 0.5 ml, IM, of Gardasil (Lot #653938/0954F), and had a recurrence of the numbness and tingling in her body. On 20-MAR-2007, the patient received her third dose, 0.5ml, IM, of Gardasil (Lot #655849/0263U), and once again had a recurrence of the numbness and tingling in her body (date unspecified). A magnetic resonance imaging test was performed (date unspecified), and was negative. At the time of this report, the nurse confirmed that the patient had not recovered. Additional information has been requested. 6/27/07-records received for DOS 3/27/07-6/15/07-On 3/27/07-presented with bilateral leg pain, numbness and tingling. No strength issues. Seeing neurologist. Note on 4/26/07-suspect restless leg syndrome for her migratory sensory discomfort in all 4 limbs and torso. Neuro exam did not show peripheral neuropathy. Note on 6/20/07-Sensory 85% better.


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