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This is VAERS ID 284130

Case Details

VAERS ID: 284130 (history)  
Age: 21.0  
Gender: Female  
Location: Washington  
Vaccinated:2007-03-16
Onset:2007-03-16
   Days after vaccination:0
Submitted: 2007-06-14
   Days after onset:90
Entered: 2007-06-18
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0188U / 0 UN / IM

Administered by: Private       Purchased by: Other
Symptoms: Body temperature increased, Hallucination, Headache, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Penicillin allergy; drug hypersensitivity
Preexisting Conditions:
Diagnostic Lab Data: body temp, 03/16/07, 103 F
CDC Split Type: WAES0705USA03139

Write-up: Information has been received from a nurse concerning a 21 year old female with allergies to amoxicillin and cefaclor and no illness at the time of vaccination who on 16-MAR-2007 was vaccinated intramuscularly with a 0.5 mL first dose of Gardasil (lot 657006/0188U). During the evening of 16-MAR-2007 the patient developed a fever of 102-103 F, a severe headache, and hallucinations. The patient was treated with alternating doses of acetaminophen and ibuprofen. By the morning of 17-MAR-2007, "all issues resolved" and the patient recovered. Additional information has been requested. 10/08/07 This is in follow-up to report(s) previously submitted on 6/14/2007. No additional information is expected.


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