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This is VAERS ID 283648

Case Details

VAERS ID: 283648 (history)  
Form: Version 1.0  
Age: 18.0  
Gender: Female  
Location: Connecticut  
Vaccinated:2007-06-21
Onset:2007-06-21
   Days after vaccination:0
Submitted: 2007-07-02
   Days after onset:11
Entered: 2007-07-03
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0525U / 2 UN / IM

Administered by: Other       Purchased by: Other
Symptoms: Blood human chorionic gonadotropin negative, Dyspnoea, Mobility decreased, Paraesthesia oral, Sensation of heaviness
SMQs:, Anaphylactic reaction (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: beta-human chorionic 06/21?/07 - negative
CDC Split Type: WAES0706USA04917

Write-up: Information has been received from a medical assistant concerning an 18 year old female with no pertinent medical history who on 16-APR-2007 was vaccinated with 0.5 ml of the first dose of the Gardasil. On 21-JUN-2007 at 8:45 am, the patient was vaccinated intramuscularly with 0.5 ml of the second dose of Gardasil (Lot # 658100/0525U). There was no concomitant medication. A laboratory pregnancy test was performed and the result was negative. On 21-JUN-2007, at noon, the patient experienced shortness of breath, intermittent tingling of the lips and the feeling of her arm being heavy and difficult to lift. The motion of the patient''s arm had gotten worse since 21-JUN-2007 and she found it difficult to do her hair because of the arm. Patient was scheduled to be evaluated at her physician''s office on 26-JUN-2007. At the time of the report, the patient''s shortness of breath, intermittent tingling of the lips, and feeling of her arm being heavy and difficult to lift persisted. The medical assistant considered the shortness of breath, intermittent tingling of the lips and feeling of her arm being heavy and difficult to lift to be a disabling event. Additional information has been requested.


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