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This is VAERS ID 425246

Case Details

VAERS ID: 425246 (history)  
Form: Version 1.0  
Age: 15.0  
Gender: Female  
Location: Florida  
   Days after vaccination:0
Submitted: 2011-06-10
   Days after onset:15
Entered: 2011-06-13
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Activities of daily living impaired, Dyspnoea, Feeling abnormal, Headache
SMQs:, Anaphylactic reaction (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type: WAES1106USA00881

Write-up: Information has been received from a certified medical assistant concerning a 15 year old female patient with no pertinent medical history and no drug reactions or allergies who on 26-MAY-2011 was vaccinated intramuscularly with the first 0.5ml dose of GARDASIL in her right arm (lot # 667878/0180AA, expiration: 08-MAR-2013). There was no concomitant medication or vaccines administered on 26-May-2011. The certified medical assistant reported that on 26-MAY-2011 ("the same day") the patient began to experience shortness of breath, which the patient described as "she walked a few steps and she could not catch her breath". The patient was a dancer who normally danced 4 times per week, she had been unable to dance or perform daily activities due to the shortness of breath. The dyspnea was not improving and shortness of breath was reported as "severe". The certified medical assistant also reported a constant headache, and just an overall feeling of being "off". No treatment was given for the adverse events and no lab diagnostics studies were performed. At the time of reporting, the patient had not recovered. The patient was referred to her primary physician for follow-up. The reporter considered the events to be disabling as the patient was having difficulties with her activities and routines. Additional information has been requested.

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