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This is VAERS ID 264745

(NOTE: This result is from the 1/15/2012 version of the VAERS database)

Case Details

VAERS ID: 264745 (history)  
Form: Version .0  
Age: 15.0  
Sex: Female  
Location: Maine  
Vaccinated:2006-08-31
Onset:2006-09-06
   Days after vaccination:6
Submitted: 2006-10-13
   Days after onset:37
Entered: 2006-10-17
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0637F / 0 UN / IM
TDAP: TDAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / UN

Administered by: Private       Purchased by: Other
Symptoms: Abdominal distension, Amniocentesis abnormal, Antibiotic resistant Staphylococcus test negative, Appendicectomy, Bacterial infection, Bilirubin conjugated increased, Blood albumin decreased, Blood alkaline phosphatase increased, Blood bilirubin increased, Blood chloride increased, Blood culture positive, Blood pH decreased, Blood potassium increased, Caesarean section, Central venous catheterisation, Chest X-ray abnormal, Colonic stenosis, Culture negative, Drug screen positive, Fear of pregnancy, Foetal disorder, Foetal growth restriction, Gastroschisis, Haematocrit decreased, Haemoglobin decreased, Intestinal anastomosis, Intestinal resection, Maternal exposure during pregnancy, Mean cell haemoglobin concentration increased, Mean cell haemoglobin increased, Mean cell volume increased, Nitrite urine present, PCO2 increased, PO2 increased, Parenteral nutrition, Platelet count decreased, Protein total decreased, Red blood cell count decreased, Red cell distribution width increased, Total lung capacity decreased, Ultrasound antenatal screen abnormal, Umbilical cord abnormality, Unintended pregnancy, Urinary system X-ray, Urine colour abnormal, Urine leukocyte esterase positive, Viral infection, White blood cells urine positive, X-ray abnormal
SMQs:, Liver related investigations, signs and symptoms (narrow), Acute pancreatitis (narrow), Haematopoietic erythropenia (narrow), Haematopoietic thrombocytopenia (narrow), Lactic acidosis (broad), Haemorrhage laboratory terms (broad), Systemic lupus erythematosus (broad), Congenital, familial and genetic disorders (narrow), Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Drug abuse (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal obstruction (narrow), Acute central respiratory depression (broad), Biliary system related investigations, signs and symptoms (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Foetal disorders (narrow), Normal pregnancy conditions and outcomes (narrow)

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, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Zoloft
Current Illness: Breast lump, Flu symptoms, Pregnancy NOS ( LMP = Unknown), Depression.
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Urine beta human 09/06/06 positive.
CDC Split Type: WAES0609USA02871

Write-up: Information has been received through the pregnancy registry from a nurse practitioner concerning a 15 year old female with no known drug allergies, and with depression who on 8/31/06 at 3:00pm was vaccinated IM in the right deltoid with the first dose of GARDASIL (lot 653937/0637F). Illnesses at the time of vaccination included flu symptoms and a breast lump. Concomitant therapy included Zoloft. Other vaccinations given on 9/6/06 included Tdap. On 9/6/06 the pt was seen at her physician with a complaint of continued viral illness. It was reported that the pt was aware that she was pregnant but did not disclose this information to her health care provider until after vaccination. A urine pregnancy test was performed and found to be positive. The pt was advised no to receive the second dose of HPV. At the time of this report, the outcome of the viral illness and vaccine exposure during pregnancy was not known. Follow-up information has been received from the patient''s OB-GYN. A nurse reported that the patient was last seen at 28 weeks gestation on 12-JAN-2007. At that time, she was transfered to the department of maternal-fetal medicine at a local hospital. A nurse at the maternal-fetal medicine department reported that the patient delivered via vaginal delivery a "healthy baby boy but had gastroschisis". The baby was born on 07-APR-2007 and APGAR scores were 8 and 9 at one and five minutes, respectively. The nurse was unable to provide the infant''s birhtweight and indicated that infants born with this congenital anomaly are generally hospitalized for 12 weks. The nurse could not confirm when and if thin infant had been discharged from the hospital. Additional information has been requested.


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