National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 291485

Case Details

VAERS ID: 291485 (history)  
Form: Version 1.0  
Age: 15.0  
Sex: Female  
Location: Colorado  
Vaccinated:2007-05-14
Onset:2007-05-25
   Days after vaccination:11
Submitted: 2007-09-26
   Days after onset:124
Entered: 2007-09-27
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / 3 GM / UN

Administered by: Other       Purchased by: Other
Symptoms:
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown PMH: recurrent sinusitis (allergic) & tonsillar lymphadenopathy, lymphadenitis, 11/2006. Recurrent ear infections. PE tubes x 2. Allergy: PCN.
Allergies:
Diagnostic Lab Data: Unknown LABS: CT revealed chronic extensive multifocala sinusitis. Repeat CT of neck & chest revealed diffuse lymphadenopathy including spleen. Sed rate 31 (H). RA 95 (H). Monospot (+). CMV (-). EBV (H). Needle aspiration of lymph nodes revealed reactive disease. Blood c/s neg.
CDC Split Type: WAES0709USA03419

Write-up: Information has been received from a nurse concerning a 16 year old female patient who was vaccinated with a first dose of Gardasil, and subsequently developed flu-like symptoms. The patient also developed flu-like symptoms after getting the second dose of Gardasil. After getting the third dose of Gardasil, the patient developed kidney failure and underwent respiratory arrest resulting in hospitalization. At the time of the report the patient had not recovered. Additional information has been requested. 10/8/07 Patient demographics provided by CDC. 10/19/07 Reviewed hospital medical records which reveal patient experienced neck swelling, difficulty swallowing, cough, bloody sputum, facial pressure/pain, fatigue. Admitted 5/25-5/31/2007. ID & ENT consults done. Tx w/IV antibiotics & developed red man syndrome, antibiotics changed. Improved & d/c to home on continued IV antibiotics via PICC line. To f/u w/ENT & ID, & have repeat CT scan done. Records do not have evidence of respiratory arrest or renal failure reported by manufacturer. FINAL DX: Sinusitis, lymphadenitis, parotitis & Epstein-Barr virus. 11/16/07 Reviewed vax records from provider. VAERS database updated w/same.


New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=291485


Copyright © 2019 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166