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This is VAERS ID 283730

Case Details

VAERS ID: 283730 (history)  
Form: Version 1.0  
Age: 16.0  
Gender: Female  
Location: West Virginia  
   Days after vaccination:0
Submitted: 2007-06-14
   Days after onset:87
Entered: 2007-06-18
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Private       Purchased by: Private
Symptoms: Dizziness, Inappropriate schedule of drug administration, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: None
CDC Split Type: WAES0703USA03643

Write-up: Information has been received from a health professional concerning a 16 year old white female student (142 lbs., 61.25 in.) who on 19-FEB-2007 was vaccinated with Gardasil. The patient was vaccinated with the second dose of Gardasil on 19-MAR-2007, which was only one month post dose one. The patient had no illness on the day of vaccine administration. On 22-MAR-2007 the patient experienced symptoms of hives and feeling dizzy and sought unspecified medical attention. No laboratory/diagnostic tests were performed. Subsequently, the patient recovered from symptoms of hives and feeling dizzy. Additional information is expected.

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