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This is VAERS ID 284130

Case Details

VAERS ID: 284130 (history)  
Form: Version 1.0  
Age: 21.0  
Gender: Female  
Location: Washington  
   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

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
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: 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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