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This is VAERS ID 281653

Case Details

VAERS ID: 281653 (history)  
Form: Version 1.0  
Age: 24.0  
Gender: Female  
Location: New York  
   Days after vaccination:0
Submitted: 2007-06-13
   Days after onset:73
Entered: 2007-06-14
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Blood pressure, Chest pain, Heart rate irregular, Medical observation, Nausea, Throat tightness
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Hypersensitivity (broad)

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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: medical observation 04/??/07 - Blood Pressure Monitoring
CDC Split Type: WAES0706USA00814

Write-up: Information has been received from a nurse concerning a 24 year old female patient who in April 2007, "about two months ago" was vaccinated IM with a first dose of Gardasil. Within about a half an hour, the patient experienced chest pains, nausea, tightening of the throat, and an irregular heartbeat. The nurse reported that the patient has been hospitalized twice for the irregular heartbeat since receiving Gardasil. The nurse also reported that the patient has no prior history of heartbeat irregularities. Laboratory diagnostic studies included blood pressure and monitoring. At the time of this report, the patient''s outcome was unknown. No product quality complaint was involved. Additional information has been requested.

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