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This is VAERS ID 279644

Case Details

VAERS ID: 279644 (history)  
Form: Version 1.0  
Age: 25.0  
Gender: Female  
Location: New Hampshire  
Vaccinated:2007-04-05
Onset:2007-04-05
   Days after vaccination:0
Submitted: 2007-05-14
   Days after onset:39
Entered: 2007-05-17
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0014U / 2 UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Diarrhoea, Faeces discoloured, Injection site erythema, Injection site swelling
SMQs:, Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Noninfectious diarrhoea (narrow)

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: NEXIUM
Current Illness: Gastrooesophageal reflux disease; Obesity
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0704USA06695

Write-up: Information has been received from a registered nurse (RN) concerning a 25 year old female who on 15-FEB-2007 was vaccinated iM in the left deltoid with a first dose of Gardasil lot # 653938/0954F and on 05-APR-2007 was vaccinated with a second dose of Gardasil lot # 653736/0014U. Concomitant therapy included Nexium. On 05-APR-2007 the patient developed loose green stool, injection site redness and injection site swelling. The loose green stools lasted for 24 hours and then resolved. On 27-APR-2007 patient had an office visit and it was noted that the injection site redness and swelling resolved. Additional information has been requested. 10/08/07 This is in follow-up to report(s) previously submitted on 5/14/2007. Initial and follow up information has been received from a Registered Nurse (R.N.) concerning a 25 year old female patient who on 15-FEB-2007 was vaccinated IM in left deltoid with a first dose of GARDASIL lot # 653938/0954F and on 05-APR-2007, at 1:30 PM was vaccinated with a second dose of GARDASIL lot #653736/0014U. Concomitant therapy included NEXIUM. On 05-APR-2007 the patient developed loose green stool, injection site redness and injection site swelling. The loose green stools lasted for 24 hours and then resolved. On 27-APR-2007 patient had an office visit and it was noted that the injection site redness and swelling resolved. In follow up it was indicated that on 06-APR-2007 patient recovered. Additional information is not expected.


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