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This is VAERS ID 284522

Case Details

VAERS ID: 284522 (history)  
Form: Version 1.0  
Age: 21.0  
Gender: Female  
Location: Maryland  
   Days after vaccination:0
Submitted: 2007-06-14
   Days after onset:74
Entered: 2007-06-18
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Headache

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: LEVORA
Current Illness: Penicillin allergy
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type: WAES0705USA05672

Write-up: Information (and additional information on 23-OCT-2007) has been received from a physician concerning her 21 year old daughter with a penicillin allergy who in January 2007, was vaccinated with a first dose of Gardasil. Concomitant therapy included Levora. In April 2007, the patient was vaccinated with a second dose of Gardasil. The patient was vaccinated in the morning and by the evening had developed a headache. The patient sought unspecified medical attention. The headache lasted 4 hours and was treated with TYLENOL. The vaccination was not administered at the physician''s office. The patient picked up the vaccine at the pharmacy, and her mother, who was a physician, administered the vaccine at home. The patient did not develop a headache afte rthe first injection. Additional information has been requested.

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