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This is VAERS ID 288904

Case Details

VAERS ID: 288904 (history)  
Form: Version 1.0  
Age:   
Sex: Female  
Location: Pennsylvania  
Vaccinated:2007-06-04
Onset:2007-06-04
   Days after vaccination:0
Submitted: 2007-08-23
   Days after onset:80
Entered: 2007-08-24
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Headache, Immediate post-injection reaction, Influenza like illness, Malaise, Nausea, Pain, Pain in extremity, Pulmonary embolism, Vasculitis
SMQs:, Acute pancreatitis (broad), Embolic and thrombotic events, venous (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vasculitis (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (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? Yes, 0 days
   Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Sjogren''s syndrome; General symptom
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0708USA02491

Write-up: Information has been received from a female pharmacist who is also the patient with Sjogren''s syndrome and "other health issues" who on 04-JUN-2007 was vaccinated with a first dose of Gardasil. On 04-JUN-2007 immediately post vaccination the patient did not feel good and developed pain in her left arm, nausea, and headache. On an unspecified date the symptoms resolved. On 09-JUN-2007 and 10-JUN-2007 the patient felt sick, had pains in her legs and whole body, resembling "flu like symptoms." On 18-JUL-2007 the patient developed vasculitis in her right leg. On 04-AUG-2007 the patient was hospitalized with a diagnosis of, bilateral pulmonary embolism. She was treated with 5 mg of COUMADIN daily and 81 mg of Aspirin daily. On 10-AUG-2007 the patient was discharged from the hospital. At the time of the report the patient''s outcome was unknown. The reporting pharmacist considered the events to be other important medical events. Additional information has been requested.


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