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This is VAERS ID 284466

Case Details

VAERS ID: 284466 (history)  
Form: Version 1.0  
Age: 21.0  
Gender: Female  
Location: Kentucky  
   Days after vaccination:2
Submitted: 2007-06-14
   Days after onset:91
Entered: 2007-06-18
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Private       Purchased by: Private
Symptoms: Rash, Somnolence
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (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:
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type: WAES0705USA04246

Write-up: Information has been received from a nurse practitioner concerning a 21 year old white female student with no pertinent medical history who on 13-MAR-2007 was vaccinated intramuscularly, into the left deltoid, with a second dose of Gardasil (lot #). On 15-MAR-2007 the patient developed a rash on her face, she "wanted to sleep all day and for some reason wanted to cry." Unspecified medical attention was sought. On approximately 18-MAR-2007, the patient recovered. There were no laboratory or diagnostic tests performed. It was noted that the night before the second dose of Gardasil was administered, the patient had eaten shellfish. Although there was no history of shellfish allergy, there was a family history of shellfish allergy. No further information is expected.

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