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This is VAERS ID 283781

Case Details

VAERS ID: 283781 (history)  
Form: Version 1.0  
Age: 12.0  
Gender: Female  
Location: Pennsylvania  
Submitted: 2007-06-14
Entered: 2007-06-18
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Abdominal pain, Blood bilirubin increased, Stomach discomfort
SMQs:, Liver related investigations, signs and symptoms (narrow), Acute pancreatitis (narrow), Retroperitoneal fibrosis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Biliary system related investigations, signs and symptoms (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: None
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: diagnostic laboratory, 02/??/07, high level of bilirubin
CDC Split Type: WAES0705USA01451

Write-up: Information has been received from a physician and a nurse concerning her 12 year old daughter who in early February 2007 was vaccinated IM with 0.5 ml of Gardasil. There was no concomitant medication. In early April 2007, the patient was vaccinated IM, in the left deltoid, with a second dose of Gardasil. A couple days after the patient''s second vaccination, she experienced "high abdominal pain" and an upset stomach. The patient was taken to the emergency room because the pain had not subsided however she was not admitted. She was diagnosed with a high level of bilirubin. Subsequently, she was treated with Zantac and recovered from the events. Additional information has been requested.

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