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This is VAERS ID 282383

(NOTE: This result is from the 12/31/2007 version of the VAERS database)

Case Details

VAERS ID: 282383 (history)  
Form: Version .0  
Age: 13.0  
Sex: Female  
Location: Unknown  
Vaccinated:2007-02-22
Onset:2007-02-22
   Days after vaccination:0
Submitted: 2007-06-15
   Days after onset:112
Entered: 2007-06-20
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B007AA / - LA / IM
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB141AA / - RA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1426F / - RA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U2158AA / - LA / IM

Administered by: Other       Purchased by: Unknown
Symptoms: Blood pressure increased, Chest discomfort, Cough, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Hypertension (narrow), Cardiomyopathy (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Nasonex
Current Illness: allergic to cats, nasal congestion
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: blood pressure-130/91; pulse oximetry-141; lymphocyte count 24.6; respiratory rate 20; neutrophil count 66
CDC Split Type:

Write-up: Initial report received on 07 June 2007 from another manufacturer, report# WAES0705USA05073. The initial reporter to this manufacturer had been the FDA, VAERS# not provided. Verbatim from the report: /"Information has been received from an agency concerni"ng a 13 year old female with an allergy to cats (the patient owns a cat) who on 22-FEB-2007 was vaccinated intramuscularly into the right arm with a dose of Gardasil (Lot# 655205/1426F). Concomitant therapy included MENACTRA (Lot# U2158AA) in the left arm


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20071231&IDNUMBER=282383


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