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This is VAERS ID 283966

Case Details

VAERS ID: 283966 (history)  
Form: Version 1.0  
Age: 19.0  
Gender: Female  
Location: California  
Vaccinated:2007-04-16
Onset:2007-04-16
   Days after vaccination:0
Submitted: 2007-06-14
   Days after onset:59
Entered: 2007-06-18
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0314U / UNK UN / UN

Administered by: Unknown       Purchased by: Unknown
Symptoms: Cough, Headache, Hypersensitivity, Throat irritation
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0705USA02910

Write-up: Information has been received from a physician concerning a 19 year old female who on 16-APR-2007 was vaccinated with Gardasil (Lot #657005/0314U). On 16-APR-2007 the patient experienced a cough, headache and itchy throat for two weeks after vaccination. The patient saw her primary care physician who diagnosed her with allergies and possible bronchitis. The patient was treated with loratadine (CLARITIN) and amoxicillin. Medical attention was sought. The patient''s outcome was not reported. Additional information has been requested.


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