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Case Details (Sorted by Age)

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VAERS ID:279667 (history)  Vaccinated:2007-04-11
Age:14.0  Onset:2007-04-11, Days after vaccination: 0
Gender:Female  Submitted:2007-05-14, Days after onset: 33
Location:Missouri  Entered:2007-05-17, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0705USA00170
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Information has been received from a physician concerning a 14 female who on 11-APR-2007 was vaccinated with a 0.5 mL dose of Gardasil (Lot # "03874"). Subsequently, the patient fainted 5 minutes after receiving the Gardasil. At the time of this report, the patient had recovered. No product quality complaint was involved. Additional information has been requested.

VAERS ID:279016 (history)  Vaccinated:2007-05-16
Age:14.0  Onset:2007-05-17, Days after vaccination: 1
Gender:Female  Submitted:2007-05-18, Days after onset: 1
Location:Colorado  Entered:2007-05-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Born with one kidney.
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B015AA5IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0308U1SCLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Erythema, Pain in extremity, Skin warm, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Received VAR #2 on 5/16/07 at 2 PM. On 5/17 at 7 PM patient noticed her arm hurt, was red and hot. On 5/18 at 1:15 patient walked in to school-based clinic to show us her arm. LTR of L arm is red (size: 9 cm x 7 cm), hot, a little firm to touch in one area, and slightly swollen. TX: Ice, Ibuprofen. If much worse tomorrow go to Urgent Care Clinic. RTC 5/21, Monday, for F/U.

VAERS ID:279020 (history)  Vaccinated:2007-05-14
Age:14.0  Onset:2007-05-15, Days after vaccination: 1
Gender:Female  Submitted:2007-05-18, Days after onset: 3
Location:Colorado  Entered:2007-05-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none known
Diagnostic Lab Data: none
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0308U1SCLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site induration, Injection site pain, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: One day after VAR #2 injection c/o red, hot, sore, swollen arm at injection site. The next day redness was increased in size, hot, sore, swollen, and center of erythema was firm to touch. TX: Cephalexin 500 mg PO TID x 10 days

VAERS ID:279074 (history)  Vaccinated:2007-05-16
Age:14.0  Onset:2007-05-16, Days after vaccination: 0
Gender:Female  Submitted:2007-05-21, Days after onset: 5
Location:Texas  Entered:2007-05-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)UNKNOWN MANUFACTURER 0UNRA
Administered by: Private     Purchased by: Unknown
Symptoms: Convulsion, Fall, Head injury, Headache, Injection site pain, Pyrexia, Skull X-ray
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: Seizure within 5 minutes of receiving the DTP vaccine. She fell and hit her head. Treatment consisted of icepack to the back of her head, feet up. Xray taken of head - negative. Patient ran fever for 24 hrs following incident. Is still complaining of mild headaches off and on and pain to arm where vaccine was given.

VAERS ID:279082 (history)  Vaccinated:2007-03-28
Age:14.0  Onset:2007-04-30, Days after vaccination: 33
Gender:Female  Submitted:2007-05-21, Days after onset: 21
Location:Florida  Entered:2007-05-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Recurring chest pain. Evaluated by dermatology for multiple nevi.
Preexisting Conditions: Persistent left sided chest pain of unclear origin since Jan 19, 2007. Has speckled positive ANA 1:160 since Jan 22, 2007. Cleared by cardiology and was to be seen by rheumatology.
Diagnostic Lab Data: CT Scan, MRI of head and Spine, Nerve Conduction Studies, multilpel lab studies records received 6/5/07-CXR normal. CT of brain and MRI of brain normal. MRI c-spine, t-spine and l-spine normal. EEG normal. CSF cultures negative. Hep A,B, and C negative. HSV negative. ANA equivocal but double stranded DNA negative. Lyme PCR negative. Enterovirus PCR, varicella zoster PCR negative. IgG, IgM, CMV and mycoplasmal pneumonia pending.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB148AA0IMLA
HPV4: HPV (GARDASIL)MERCK & CO. INC.018840IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2141AA0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Antinuclear antibody negative, Areflexia, Borrelia burgdorferi serology negative, CSF culture negative, Chest X-ray normal, Electroencephalogram normal, Enterovirus serology test negative, Facial palsy, Guillain-Barre syndrome, Hepatitis A antibody negative, Hepatitis B test negative, Hepatitis C test negative, Herpes simplex serology negative, Hypoaesthesia, Nerve conduction studies, Nuclear magnetic resonance imaging brain normal, Nuclear magnetic resonance imaging normal, Pain, Paraesthesia
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Demyelination (narrow)
Write-up: Patient presented 5/10/07 with a ten history of tingling in the right hand. On 5/14/07, she presented with right foot pain and numbness as well. She was referred to the Neurologist where she had an appointment 5/15/07. Patient was admitted, after ER evaluation, on 5/16/07. Patient was treated with IVIG in the hospital and multiple tests were ordered. Patient''s working diagnosis is Landry-Guillain-Barre Miller-Fisher variant. 06/05/07-records received from facility for DOS 05/16-05/21/07-DC DX: Guillain Barre variant. Left Bell''s Palsy. Paresthesias. C/O numbness in dorsum of right hand progressing up her forearm also left foot numbness progressing up her leg and a left facial droop. Numbness started in right hand approximately 1 month after received HPV, Hep A and Menactra vaccine. HX of living in woods and a family pet with ticks. PE: Crainal nerves II through XII intact with exception of mild left facial droop. Paresthesias of bilateral lower extremity and hands and arms in glove and stocking formation. Strength and motor intact. Treated with IVIG. Symptoms without progression and slight improvement daily. Lost reflex in lower extremities but at time of discharge 2+ of right but have not returned on left

VAERS ID:279141 (history)  Vaccinated:2007-04-23
Age:14.0  Onset:0000-00-00
Gender:Female  Submitted:2007-04-26
Location:Tennessee  Entered:2007-05-21, Days after submission: 25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: anxiety
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB148AA0IMRA
HPV4: HPV (GARDASIL)MERCK & CO. INC.018840IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.011141IMLA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Induration, Myalgia, Oedema peripheral
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: erythema, induration, myalgias, edema of extremities

VAERS ID:279150 (history)  Vaccinated:2007-05-11
Age:14.0  Onset:2007-05-12, Days after vaccination: 1
Gender:Unknown  Submitted:0000-00-00
Location:Georga  Entered:2007-05-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Uses Flonase, Obar, Claritin for allergies
Current Illness:
Preexisting Conditions: Allergies
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0389U0IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0445U1IMRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: 5/11/07 Received Varivax booster RA. On 5/12/07 woke up with small red, tender area at shot site. On 5/13/07 area 7-8 inches in diameter, very tender, raised red, areas. 5/14/07 area of redness decreased. Now erythema 2 inch diameter. Ice and Benadryl advised.

VAERS ID:279151 (history)  Vaccinated:2007-05-14
Age:14.0  Onset:2007-05-15, Days after vaccination: 1
Gender:Female  Submitted:2007-05-16, Days after onset: 1
Location:California  Entered:2007-05-21, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.030401 RA
HPV4: HPV (GARDASIL)MERCK & CO. INC.0181U0 LA
TDAP: TDAP (ADACEL)SANOFI PASTEURC2454AA4 LA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1512F1 RA
Administered by: Other     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Redness and swelling right deltoid region after 1 day.

VAERS ID:279152 (history)  Vaccinated:2007-05-11
Age:14.0  Onset:2007-05-11, Days after vaccination: 0
Gender:Male  Submitted:2007-05-16, Days after onset: 5
Location:Pennsylvania  Entered:2007-05-21, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.1009F0 RA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2182AA0 RA
TDAP: TDAP (ADACEL)SANOFI PASTEURC2638AA  LA
Administered by: Private     Purchased by: Public
Symptoms: Injection site bruising, Injection site swelling
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Right arm swollen - black and blue

VAERS ID:279331 (history)  Vaccinated:2007-05-15
Age:14.0  Onset:2007-05-15, Days after vaccination: 0
Gender:Male  Submitted:0000-00-00
Location:Pennsylvania  Entered:2007-05-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Asthma, Obesity
Diagnostic Lab Data: CBC, Comprehensive metabolic panel - all normal
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB115CA0IMLA
Administered by: Private     Purchased by: Other
Symptoms: Fatigue, Full blood count, Headache, Malaise, Myalgia, Nausea, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad)
Write-up: Malaise, Myalgia, fever, fatigue, headache, nausea

VAERS ID:279114 (history)  Vaccinated:2007-05-20
Age:14.0  Onset:2007-05-21, Days after vaccination: 1
Gender:Female  Submitted:2007-05-21, Days after onset: 0
Location:Minnesota  Entered:2007-05-22, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Wellbutrin, Lovatadine, Vitamin C, Calcium, Triamcinaolone spray
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: none
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB143BA0IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2222AA0IMRA
Administered by: Other     Purchased by: Public
Symptoms: Injection site rash, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Child received Menactra Hep A in right deltoid on 5/20.07. The next day developed a rash and swelling at the injection site. No temp.

VAERS ID:279265 (history)  Vaccinated:2007-05-14
Age:14.0  Onset:2007-05-14, Days after vaccination: 0
Gender:Female  Submitted:2007-05-17, Days after onset: 3
Location:North Carolina  Entered:2007-05-22, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: LEXAPRO
Current Illness: Allergic rhinitis, sinusitis
Preexisting Conditions: None
Diagnostic Lab Data: CT Scan of head and skull X-ray (-) (obtained secondary to fall/ head injury)
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0181U0IMRA
Administered by: Private     Purchased by: Private
Symptoms: Computerised tomogram normal, Head injury, Pyrexia, Syncope, X-ray normal
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: 1. Syncope shortly after with head injury (contusion) had CT scan in ER next day which was ok. 2. Fever next day (101.2)

VAERS ID:279304 (history)  Vaccinated:2007-05-18
Age:14.0  Onset:2007-05-19, Days after vaccination: 1
Gender:Female  Submitted:2007-05-22, Days after onset: 3
Location:Connecticut  Entered:2007-05-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Celexa
Current Illness:
Preexisting Conditions: Sulfa Allergy
Diagnostic Lab Data: CBC WNL
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2278AA0IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0365U1SCLA
Administered by: Private     Purchased by: Private
Symptoms: Full blood count, Injection site erythema, Injection site induration, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: 11 x 9 cm area of erythema and warmth and induration at site of injection L deltoid. No fever

VAERS ID:279306 (history)  Vaccinated:2007-05-07
Age:14.0  Onset:2007-05-13, Days after vaccination: 6
Gender:Female  Submitted:2007-05-16, Days after onset: 3
Location:Texas  Entered:2007-05-22, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B012AA0IMLA
Administered by: Other     Purchased by: Public
Symptoms: Dyspnoea, Hypersensitivity
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: Tdap given 5-7-07 - student states after being out and about on 5-12-07, in th evening she began to have difficulty breathing. Mom took to ER. Dr said was allergic reaction but no specific source diagnosed. Student given steroids by Dr and sent home - Prednisone and Benadryl (went to ER on 5/13/07)

VAERS ID:279433 (history)  Vaccinated:2007-05-16
Age:14.0  Onset:2007-05-17, Days after vaccination: 1
Gender:Female  Submitted:2007-05-21, Days after onset: 4
Location:New York  Entered:2007-05-23, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: allergic rhinitis, allergen to ragweed pollen, mites and house dust
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0UNLA
Administered by: Private     Purchased by: Private
Symptoms: Laboratory test, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Urticarial rash began about 24 hours after vaccines were given patient also had bloodwork drawn after receiving her vaccine. Patient returned to office 2 days after vaccine was given; rash improved with Benadryl somewhat completely improved with Atarax.

VAERS ID:279727 (history)  Vaccinated:1995-09-07
Age:14.0  Onset:2006-02-25, Days after vaccination: 3824
Gender:Female  Submitted:2007-05-16, Days after onset: 444
Location:Illinois  Entered:2007-05-24, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: chickenpox~Varicella (Varivax)~~12~In Sibling
Other Medications: None
Current Illness: Sulfonamide allergy
Preexisting Conditions:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0603USA03381
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Varicella, Varicella post vaccine
SMQs:
Write-up: Information has been received from a health professional concerning a 14 year old female with a sulfonamide allergy and no medical history who on 07-SEP-1995 was vaccinated with a 0.5ml dose of Varivax (Oka/Merck) (diluent lot # 513486/1527A). There was no concomitant medication. On 25-FEB-2006 the patient experienced a severe case of chicken pox with greater than 200 lesions. The patient was recovered as of 21-MAr-2006. Unspecified medical attention was sought. No product quality complaint was involved. Follow-up information from a health professional indicated that on 25-FEB-2006 the patient developed a full blown case of chickenpox, with hundreds of lesions. The reporter considered the patient''s reaction to be an other important medical event. The patient''s brother (WAES 0603USA03382) had a similar reaction after vaccination with Varivax. Additional information is not expected.

VAERS ID:281790 (history)  Vaccinated:2006-11-13
Age:14.0  Onset:2006-11-15, Days after vaccination: 2
Gender:Female  Submitted:2007-05-16, Days after onset: 181
Location:Unknown  Entered:2007-05-24, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type': WAES0611USA04903
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0914R0SCUN
Administered by: Other     Purchased by: Other
Symptoms: Injection site discomfort, Injection site erythema, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Information has been received from a nurse practitioner (NP) concerning a 14-year-old female with no medical history or allergies who on 13-NOV-2006 was vaccinated SC in the right arm with the first 0.5 mL dose of varicella virus vaccine live (Oka/Merck) (Lot #650388/0914R). There was no concomitant therapy. The NP reported 15-NOV-2006, the patient developed a 3-4 inch area if redness, swelling, warmth and discomfort at injection site of her right arm. On that same day, the patient was examined and ice compresses and ibuprofen were prescribed. No laboratory/diagnostic tests were performed. Follow-up appointments were scheduled for 16-NOV-2006 and 17-NOV-2006. At that time of this report, the patient''s events persisted. Additional information has been requested.

VAERS ID:281795 (history)  Vaccinated:0000-00-00
Age:14.0  Onset:2005-01-01
Gender:Female  Submitted:2007-05-16, Days after onset: 864
Location:Unknown  Entered:2007-05-24, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0611USA05120
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  SCUN
Administered by: Other     Purchased by: Other
Symptoms: Herpes zoster
SMQs:
Write-up: Information has been received from a physician''s assistant concerning a 14-year-old female who was vaccinated SC with a 0.5mL dose of Varivax. In approximately 2005 the patient developed a rash and was diagnosed with shingles. Unspecified medical attention was sought. Subsequently, in approximately 2005, the patient recovered. There was no product quality complaint. No additional information is expected.

VAERS ID:281823 (history)  Vaccinated:2006-12-06
Age:14.0  Onset:2006-12-06, Days after vaccination: 0
Gender:Female  Submitted:2007-05-16, Days after onset: 160
Location:Ohio  Entered:2007-05-24, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type': WAES0612USA01400
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0UNUN
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1142F1IMUN
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Information has been received from a physician concerning a 14 year old female, with no medical history, who on 06-DEC-2006 was vaccinated with a second intramuscular dose in the right arm of Varivax (Lot# 655065/1142F). Concomitant vaccine administered on the same day included a first dose in the right arm of Gardasil (Lot# "0916F"). It was reported that, on 06-DEC-2006, the patient''s injection site swelled to the size of a golf ball, and had become red and tender but developed no fever. The patient was treated with ice. At the time of the report the patient was recovering. There were no laboratory diagnostic tests performed. Unspecified medical attention was sought. No product quality complaint was involved. No other information was provided. Additional information has been requested.

VAERS ID:281883 (history)  Vaccinated:2007-01-18
Age:14.0  Onset:0000-00-00
Gender:Female  Submitted:2007-05-16
Location:Missouri  Entered:2007-05-24, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0701USA03640
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1143F UNUN
Administered by: Private     Purchased by: Other
Symptoms: Cellulitis
SMQs:
Write-up: Information has been received from a physician concerning a 14 year old female who on 18-JAN-2007 was vaccinated with Varivax (Lot 655066/1143F). Subsequently the patient developed cellulitis. The patient sought unspecified medical attention. Patient outcome was not reported. Additional information has been requested.

VAERS ID:281892 (history)  Vaccinated:2007-01-11
Age:14.0  Onset:2007-01-15, Days after vaccination: 4
Gender:Female  Submitted:2007-05-16, Days after onset: 120
Location:Unknown  Entered:2007-05-24, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0701USA04214
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Varicella
SMQs:
Write-up: Information has been received from a registered nurse concerning a 14 year old female who on 11-JAN-2007 was vaccinated with Varivax (lot # not provided). On 15-JAN-2007, the patient experienced breakthrough varicella rash after receiving Varivax. The nurse reported that the patient had approximately 50 lesions or more. The patient outcome was not reported. There was no product quality complaint.

VAERS ID:282086 (history)  Vaccinated:1997-01-17
Age:14.0  Onset:2007-03-02, Days after vaccination: 3696
Gender:Male  Submitted:2007-05-16, Days after onset: 74
Location:Unknown  Entered:2007-05-24, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type': WAES0703USA01512
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1105D UNGM
Administered by: Other     Purchased by: Other
Symptoms: Varicella, Varicella post vaccine
SMQs:
Write-up: Information has been received from a medical assistant concerning a 14 year old male, with no pertinent medical history, drug reactions or allergies; who on 17-JAN-1997 was vaccinated with 0.5 ml of varicella virus vaccine live (Oka/Merck) (Lot#620617/1105D), and subsequently on 02-MAR-2007 was diagnosed with breakthrough chickenpox. No details were provided regarding the number of lesions, present status of patient, etc. Unspecified medical attention was sought. There was no product quality complaint. No lab diagnostic studies were performed. Additional information has been requested.

VAERS ID:279701 (history)  Vaccinated:2007-05-15
Age:14.0  Onset:2007-05-16, Days after vaccination: 1
Gender:Unknown  Submitted:0000-00-00
Location:Maine  Entered:2007-05-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Penicillin allergy
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2278AA0IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC2631AA0IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1041F1SCRA
Administered by: Private     Purchased by: Unknown
Symptoms: Erythema, Pain, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Swelling and redness at right arm painful no itching or rash no signs infection. Seen 5/17/07

VAERS ID:279817 (history)  Vaccinated:2007-05-13
Age:14.0  Onset:2007-05-14, Days after vaccination: 1
Gender:Male  Submitted:2007-05-25, Days after onset: 11
Location:Oregon  Entered:2007-05-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Clindamycin
Current Illness: cellulitis of eye brow
Preexisting Conditions: none
Diagnostic Lab Data: none
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC2610AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Chills, Injection site swelling, Myalgia, Nausea, Pharyngolaryngeal pain, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad)
Write-up: Swelling at injection site, chills, fever, nausea, sore throat, muscle aches in arms and legs.

VAERS ID:279893 (history)  Vaccinated:2007-05-14
Age:14.0  Onset:2007-05-14, Days after vaccination: 0
Gender:Female  Submitted:2007-05-25, Days after onset: 11
Location:Kentucky  Entered:2007-05-29, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: blood pressure 05/14/07 72/48 mmHg, total heartbeat count 05/14/07 38bpm
CDC 'Split Type': WAES0705USA04237
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0388U2IMLA
Administered by: Private     Purchased by: Other
Symptoms: Blood pressure decreased, Dyskinesia, Heart rate decreased, Heart rate increased, Hypotension, Immediate post-injection reaction, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dyskinesia (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow)
Write-up: Information has been received from a health professional, concerning a 14 year old female student, with no known drug allergies, who on 14-MAY-2007, at 3:00pm, was vaccinated IM in the left arm, with the third dose of Gardasil (Lot #657622/0388U). There was no illness at the time of vaccination. The reporter indicated that immediately after vaccination, at 3:00pm, on 14-MAY-2007 the patient "passed out and started jerking all over the shot was given" (duration of symptoms and treatment were not reported). The patient''s vital signs included a blood pressure of 72/48mmHg, and a pulse of 38bpm. The reporter confirmed that the patient recovered on the same day, 14-MAY-2007. The reporter stated that the events of passed out, jerking all over, pulse very low and blood pressure very low, required medical intervention to prevent serious criteria, and were considered as an other important medical event. Additional information has been requested.

VAERS ID:279929 (history)  Vaccinated:2007-05-03
Age:14.0  Onset:2007-05-03, Days after vaccination: 0
Gender:Male  Submitted:2007-05-03, Days after onset: 0
Location:Texas  Entered:2007-05-29, Days after submission: 26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Dizziness
Preexisting Conditions: None
Diagnostic Lab Data: BP 95/60 before 90/53 after shot
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU1920AA0 RA
Administered by: Private     Purchased by: Public
Symptoms: Blood pressure decreased, Dizziness, Vision blurred
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad)
Write-up: Pt c/o feeling dizzy within 5 min of being vaccinated with MCV4, pt c/o seeing blurry pt stayed on office 30 min

VAERS ID:280118 (history)  Vaccinated:2007-05-29
Age:14.0  Onset:2007-05-31, Days after vaccination: 2
Gender:Male  Submitted:2007-05-31, Days after onset: 0
Location:Texas  Entered:2007-05-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: 50MM X 50MM SWELLING~Varicella (Varivax)~2~14~In Patient
Other Medications: BENZACLYN, TETRACYCLIN, RECIEVES ALLERGY SHOTS FROM ALLERGIST
Current Illness: GOOD HEALTH
Preexisting Conditions: SEVERE ALLERGIES
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1060F1SCLA
Administered by: Private     Purchased by: Private
Symptoms: Reaction to preservatives
SMQs:, Hypersensitivity (narrow)
Write-up: REATION ON L ARM TO SC VZV, MEASURED 50MM X 50MM

VAERS ID:280159 (history)  Vaccinated:2006-11-06
Age:14.0  Onset:2006-11-20, Days after vaccination: 14
Gender:Female  Submitted:2007-05-31, Days after onset: 191
Location:Unknown  Entered:2007-06-01, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Trileptal
Current Illness:
Preexisting Conditions: Convulsion
Diagnostic Lab Data: None
CDC 'Split Type': WAES0705USA05000
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  UNUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Convulsion
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: Information has been received from a consumer concerning her 14 year old daughter with a history of seizures who on 06-NOV-2006 was vaccinated with a 1st dose of Gardasil. Concomitant therapy included oxcarbazepine (TRILEPTAL). Two weeks after getting the first dose of Gardasil she developed a seizure. She sought medical attention, and no lab diagnostic studies were performed. Subsequently she recovered. As of 24-MAY-2007 she had yet to get the second and third dose of Gardasil. Upon internal review, seizure was determined to be an other important medical event. Additional information has been requested.

VAERS ID:280178 (history)  Vaccinated:2007-05-30
Age:14.0  Onset:2007-05-30, Days after vaccination: 0
Gender:Male  Submitted:0000-00-00
Location:Minnesota  Entered:2007-06-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Singulair 10mg Albinh and Alb nebs
Current Illness: yes, sore throat, Runny nose, no fever
Preexisting Conditions: Asthma
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2068AA0IMRA
Administered by: Private     Purchased by: Private
Symptoms: Dyspnoea, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: 6 hrs after given Menactra developed SOB/wheezing. Used inhaler but wheezing worsened overnite. Was going to use Neb but then improved on own by next day. No rash/fever.

VAERS ID:280274 (history)  Vaccinated:2007-05-16
Age:14.0  Onset:2007-05-27, Days after vaccination: 11
Gender:Male  Submitted:2007-05-29, Days after onset: 2
Location:California  Entered:2007-06-04, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Topamax
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: none
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEUR42223AA0 RA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0783H0SCRA
Administered by: Private     Purchased by: Public
Symptoms: Varicella post vaccine
SMQs:
Write-up: VZV vaccine #1 given 5-16-07. Developed varicella disease on 5-27-07.

VAERS ID:280438 (history)  Vaccinated:2007-05-14
Age:14.0  Onset:2007-05-16, Days after vaccination: 2
Gender:Female  Submitted:2007-05-29, Days after onset: 13
Location:California  Entered:2007-06-05, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Albuterol Inh Claritin prn
Current Illness: none
Preexisting Conditions: food allergies
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0384U2IMLA
Administered by: Private     Purchased by: Private
Symptoms: Skin papilloma
SMQs:
Write-up: Pt developed small pimple on inner side of middle phalanx of little finger left on wk after HPV vaccine #3. 2 days later developed wart at site. Within on day was the size of pts finger on same finger (8-10mm). Mom treating at home with freeze spray.

VAERS ID:282557 (history)  Vaccinated:2007-02-26
Age:14.0  Onset:2007-02-26, Days after vaccination: 0
Gender:Female  Submitted:2007-05-25, Days after onset: 87
Location:Texas  Entered:2007-06-06, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Cardiac disorder
Diagnostic Lab Data: None
CDC 'Split Type': WAES0703USA00495
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.1281F IMRA
HPV4: HPV (GARDASIL)MERCK & CO. INC.  UNUN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEUR  UNUN
TDAP: TDAP (ADACEL)SANOFI PASTEUR  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site pain, Injection site reaction, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Information ahs been received from a registered nurse concerning a 14 year old female with a "cardiac history" and no drug reactions/allergies who on 26-FEB-2007 was vaccinated intramuscularly in the right arm one dose of VAQTA (lot # 656320/1281F). Concomitant therapy included GARDASIL, ADACEL and MENACTRA. On 26-FEB-2007 the patient experienced an injection site reaction from the vaccination. The reaction consisted of redness, swelling and pain in the right arm. The patient sought unspecified medical attention. The patient was seen by the physician on 01-MAR-2007 and was still having the symptoms. No diagnostic laboratory tests were performed. At the time of the report the patient was recovering. There was no product quality complaint. The records of testing prior to release of the lot in question have been rechecked and found to be satisfactory. The lot met requirements of the CBER and was released by the regulatory agency. Additional information has been requested.

VAERS ID:280870 (history)  Vaccinated:2007-06-05
Age:14.0  Onset:2007-06-06, Days after vaccination: 1
Gender:Female  Submitted:2007-06-07, Days after onset: 1
Location:California  Entered:2007-06-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: n/a
Current Illness: n/a
Preexisting Conditions: NKA
Diagnostic Lab Data: n/a
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0523U2IMLA
Administered by: Private     Purchased by: Private
Symptoms: Anorexia, Cold sweat, Discomfort, Dizziness, Fatigue, Nausea, Pallor
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Extremely dizzy, nausea, tiredness, loss of appetite, pale color, no fever but very uncomfortable/"clammy". Had vaccine (3rd of series) on June 5 and symptoms began the following day. Are still present today, but doing better.

VAERS ID:280892 (history)  Vaccinated:2007-06-07
Age:14.0  Onset:2007-06-07, Days after vaccination: 0
Gender:Female  Submitted:2007-06-07, Days after onset: 0
Location:Indiana  Entered:2007-06-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No-after appt.
Preexisting Conditions: Cerebral palsy, seizure disorder
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2172AA0IMRA
Administered by: Other     Purchased by: Public
Symptoms: Grand mal convulsion
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: upper extremity 10 minute Tonic Clonic seizure suffered in parking lot after appt. transported by paramedics to hospital.

VAERS ID:281022 (history)  Vaccinated:2007-03-08
Age:14.0  Onset:2007-04-08, Days after vaccination: 31
Gender:Female  Submitted:2007-06-07, Days after onset: 60
Location:California  Entered:2007-06-08, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None PMH: URI, sore throat & fever approx April 3. Back pain began approx April 4 w/paresthesias beginning approx April 5-6.
Diagnostic Lab Data: None LABS: MRI of LS spine done prior to admit was WNL. WBC 8,300, neutros 62, lymphs 30, monos 7, eos 1. ESR is 16. CSF glucose 61, protein 44, lymphs 100, c/s neg. MRI repeated on 4/18 revealed presumed discogenic disease at T10-11 an
CDC 'Split Type': WAES0706USA00562
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0637F1UNUN
Administered by: Other     Purchased by: Other
Symptoms: Back pain, CSF culture negative, CSF lymphocyte count increased, Depression, Diplegia, Hyperreflexia, Hypoaesthesia, Hypotonia, Myelitis transverse, Nuclear magnetic resonance imaging abnormal, Nuclear magnetic resonance imaging normal, Pain in extremity, Paraesthesia, Paralysis flaccid, Red blood cell sedimentation rate normal, Wheelchair user, White blood cell count
SMQs:, Peripheral neuropathy (broad), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Demyelination (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Depression (excl suicide and self injury) (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Malignant lymphomas (broad)
Write-up: Information has been received from a physician, via a company representative, concerning a 14 year old female patient, who on 11-JAN-2007 was vaccinated with the first dose, 0.5ml, of Gardasil, with no adverse events reported, and on 08-MAR-2007 was vaccinated with the second dose, 0.5ml, of Gardasil. There was no concomitant medication. On 08-APR-2007, the patient had experienced "extreme leg and back pain" and was diagnosed with acute transverse myelitis; she was hospitalized. The duration of hospitalization was not known. At the time of this report, the patient had not recovered from the acute transverse myelitis. Additional information has been requested. 6/19/07 Received PCP medical records which included vax records w/lot & dose #s. VAERS database updated w/same. ALso included was hospital d/c summary which reveals patient admitted 4/17-4/20/07 with severe LE pain which had progressively worsened. Seen by PCP who sent to neurologist prior to admit . Admitted for high dose steroids & close observation. Improved dramatically & d/c to home w/PCP & neuro f/u. Seen by neuro in f/u on 4/23/07 being transported by ambulance on a gurney due to total paralysis of both LEs. Also had severe depression. 5/18/07 w/only partial recovery. Continued to have severe low back & LE pain despite fentanyl patch & PT. Was unable to ambulate & was w/c bound. Exam revealed severe flaccid hypotonic muscle weakness of LEs w/hyperreflexia. Bladder & bowel function were intact. Patch increased & was to continue PT. 7/3/07 Received hospital medical records which reveal patient experienced severe LE pain which had progressively worsened. Admitted 4/17-4/20/07 for IV steroids & pain management. Patient had URI w/sore throat & fever approx 3-4 wks prior to admit treated w/antibiotics. Then developed back pain which worsened & LEs also became numb. Seen by PCP who consulted neurosurgeon & MRI was done which was neg. Patient continued to worsen & was seen by neurologist who dx w/transverse myelitis & admitted to hospital.

VAERS ID:281108 (history)  Vaccinated:2007-05-11
Age:14.0  Onset:2007-06-01, Days after vaccination: 21
Gender:Female  Submitted:2007-06-15, Days after onset: 14
Location:California  Entered:2007-06-11, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: thyroid goiter
Diagnostic Lab Data: vv
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0171U1 LA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2082AA0 RA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0369U0 LA
Administered by: Public     Purchased by: Unknown
Symptoms: Varicella, Varicella post vaccine
SMQs:
Write-up: Patient had chickenpox after receiving varicella immunization. Had mild amount of involvement of legs, chrisind face.

VAERS ID:281123 (history)  Vaccinated:2007-06-05
Age:14.0  Onset:2007-06-07, Days after vaccination: 2
Gender:Female  Submitted:2007-06-08, Days after onset: 1
Location:Texas  Entered:2007-06-11, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2181AA0IMRL
TDAP: TDAP (ADACEL)SANOFI PASTEURC2572AA5IMLL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0453U1SCRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site pain, Nodule, Rash
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: She had a red knot with a bumpy rash and it was painful at the site where she received Varivax in her right arm on 6/5/07.

VAERS ID:281383 (history)  Vaccinated:2007-05-21
Age:14.0  Onset:2007-05-21, Days after vaccination: 0
Gender:Male  Submitted:2007-05-21, Days after onset: 0
Location:Texas  Entered:2007-06-12, Days after submission: 22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None noted
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type': TX07052
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2181AA0IMRA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B007AA0IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0364U1SCRA
Administered by: Public     Purchased by: Public
Symptoms: Dizziness, Pallor
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: 14 year old male was seen at clinic for immunization administration. Child received the following vaccines: Tdap, Varicella and MCV4. Immediately after administration of vaccines child felt faint and got pale in color. Symptoms lasted a few seconds. Child monitored. Child voiced he felt better. Advised mother to stay a few more minutes before leaving. F/U with MD. Supervisor aware. Child ambulated out of clinic.

VAERS ID:281568 (history)  Vaccinated:2007-03-12
Age:14.0  Onset:2007-03-12, Days after vaccination: 0
Gender:Female  Submitted:2007-06-13, Days after onset: 93
Location:Georga  Entered:2007-06-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Thyroid
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  SC 
Administered by: Private     Purchased by: Unknown
Symptoms: Dizziness
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)
Write-up: Pt. states she was dizzy for a short time after recieving vaccine.

VAERS ID:281669 (history)  Vaccinated:0000-00-00
Age:14.0  Onset:0000-00-00
Gender:Unknown  Submitted:0000-00-00
Location:Unknown  Entered:2007-06-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC2720AA IM 
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1302F SC 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Pyrexia, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: Fever 102.5 with diffuse erythematous rash day after vaccine given.

VAERS ID:281710 (history)  Vaccinated:2007-06-13
Age:14.0  Onset:2007-06-13, Days after vaccination: 0
Gender:Female  Submitted:2007-06-14, Days after onset: 1
Location:New Mexico  Entered:2007-06-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: none
Preexisting Conditions: none known
Diagnostic Lab Data: Electrolytes
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (DAPTACEL)SANOFI PASTEURC2690AA IMLA
Administered by: Unknown     Purchased by: Private
Symptoms: Blood electrolytes, Blood potassium decreased, Dizziness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Patient complained of dizziness and fainted about 2 hours after vaccine was administered. Patient was taken to ER. Blood work showed low potassium. Patient was prescribed potassium supplement.

VAERS ID:281927 (history)  Vaccinated:2007-06-08
Age:14.0  Onset:2007-06-08, Days after vaccination: 0
Gender:Female  Submitted:2007-06-12, Days after onset: 4
Location:Ohio  Entered:2007-06-15, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lexapro
Current Illness: none
Preexisting Conditions: Amoxil allergy
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0389U0IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2278AA0IMRA
Administered by: Private     Purchased by: Private
Symptoms: Loss of consciousness, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: Passed out, vomiting

VAERS ID:283257 (history)  Vaccinated:2007-05-25
Age:14.0  Onset:2007-05-25, Days after vaccination: 0
Gender:Male  Submitted:2007-06-14, Days after onset: 20
Location:Pennsylvania  Entered:2007-06-18, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0705USA05762
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.0162U UNUN
Administered by: Other     Purchased by: Other
Symptoms: No adverse reaction, Wrong drug administered
SMQs:
Write-up: Information has been received from a physician concerning a 14 year old male who on 25-MAY-2007 was vaccinated with a dose of Zostavax (lot # 656394/0162U) instead of Varivax. The physician reported that the practice ordered Varivax and Zostavax was sent by the pharmacy. The vaccine was put in the freezer where Varivax is normally kept and the medical assistant administered the vaccine assuming it was Varivax. The medical assistants will now be double checking all medications prior to administration. As of 07-JUN-2007 the patient was fine, there was no fever or rash. There was no product quality complaint involved. This is one of several reports from the same reporter. Additional information has been requested.

VAERS ID:283804 (history)  Vaccinated:2007-03-05
Age:14.0  Onset:2007-03-07, Days after vaccination: 2
Gender:Female  Submitted:2007-06-14, Days after onset: 98
Location:Ohio  Entered:2007-06-18, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0705USA02020
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1427F0UNRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU1947AA0UNRA
Administered by: Private     Purchased by: Private
Symptoms: Menstruation irregular
SMQs:, Fertility disorders (broad)
Write-up: Information has been received from a physician and an LPN concerning a 14 year old female who on 05-MAR-2007 at 10:45 a.m. was vaccinated in the right deltoid with the first 0.5 mL dose of Gardasil (lot# 655619/1427F). Concomitant vaccination given in the right deltoid on 05-MAR-2007 included MENACTRA (lot # U1947AA). It was reported that the patient was vaccinated on day 4 of her menses. Her menses stopped for 2 days and re-started on 07-MAR-2007 and continued through 13-MAR-2007 (described as a normal cycle. During this time she had normal cramps and no treatment was given. Her cycle returned to normal occurring 28 days later. The patient reported that she is on a normal 28-day menstrual cycle since the age of 13 years. The patient was not on birth control. No further information is expected.

VAERS ID:283805 (history)  Vaccinated:0000-00-00
Age:14.0  Onset:0000-00-00
Gender:Female  Submitted:2007-06-14
Location:Unknown  Entered:2007-06-18, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0705USA02022
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Injection site pain, Menstruation irregular
SMQs:, Extravasation events (injections, infusions and implants) (broad), Fertility disorders (broad)
Write-up: Information has been received from an office staff concerning her 14 year old daughter who was vaccinated with the first 0.5 mL dose of Gardasil and two days later had her first menstrual cycle. The patient had no menses in between shots and had her second menstrual cycle after receiving the second dose of Gardasil. The patient also experienced injection site pain. The patient sought unspecified medical attention. The patient''s status was not reported. There was no product quality complaint involved. No further information is available.

VAERS ID:283932 (history)  Vaccinated:2007-04-01
Age:14.0  Onset:2007-05-01, Days after vaccination: 30
Gender:Female  Submitted:2007-06-14, Days after onset: 44
Location:Unknown  Entered:2007-06-18, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data:
CDC 'Split Type': WAES0705USA02180
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  IMUN
Administered by: Private     Purchased by: Other
Symptoms: Injection site erythema, Injection site induration, Injection site pain, Injection site reaction, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Information has been received from a certified medical assistant and a physician (patient''s dermatologist) concerning a 14 year old female student who was vaccinated in April 2007 with her third dose of Gardasil in the left arm and developed an injection site reaction. There was no concomitant medication. In May 20007 the patient developed left arm swelling, redness, tenderness and warm and firm to touch. The patient noted this did not happen with the first and second injections. The patient had recovered three weeks post injection. The patient''s OB/GYN office who administered the Gardasil was not concerned. The patient''s mother was concerned and took her to a dermatologist. Cool compresses were recommended for the patient. Additional information has been requested.

VAERS ID:283945 (history)  Vaccinated:2007-05-10
Age:14.0  Onset:2007-05-10, Days after vaccination: 0
Gender:Female  Submitted:2007-06-14, Days after onset: 35
Location:New York  Entered:2007-06-18, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type': WAES0705USA02397
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0962F IMUN
Administered by: Other     Purchased by: Other
Symptoms: Feeling of body temperature change, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Information has been received from a physician''s assistant concerning a 14 year old female with no known drug allergies who on 10-MAY-2007 was vaccinated with a dose of GARDASIL, 0.5ml, intramuscularly (Lot# 654510/0962F). Concomitant therapy included hormonal contraceptives (unspecified). Within 24 hours of being vaccinated on 10-MAY-2007, the patient felt feverish and developed a small red rash on her abdomen, back and between her fingers. The patient''s mother treated her with over the counter BENADRYL. On 11-MAY-2007, the patient recovered. Additional information has been requested. 10/08/07 This is in follow-up to report(s) previously submitted on 6/14/2007. Additional information is not expected.

VAERS ID:283949 (history)  Vaccinated:2006-12-11
Age:14.0  Onset:2006-12-11, Days after vaccination: 0
Gender:Female  Submitted:2007-06-14, Days after onset: 184
Location:Ohio  Entered:2007-06-18, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown; Reflex sympathetic dystrophy
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0705USA02557
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0637F1IMUN
Administered by: Private     Purchased by: Private
Symptoms: Asthenia, Dizziness, Nausea, Pallor, Stomach discomfort
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Information has been received from a nurse concerning a "14 or 15" year old female who was vaccinated intramuscularly with a 0.5 mL second dose of Gardasil. Subsequently the patient experienced nausea, was white in the face, and sick to the stomach. The patient sought unspecified medical attention. Subsequently, the patient recovered. This is one of several reports from the same source. Additional information has been requested. This is in follow-up report(s) previously submitted on 6/14/2007; 7/6/2007. Information has been received from a nurse concerning a 13 year old female with a history of reactive sympathetic dystrophy, who on 11-DEC-2006 was vaccinated intramuscularly in the left deltoid with a 0.5 mL second dose of GARDASIL (lot# 653937/0637F). Subsequently the patient experienced sick "queasy" to the stomach, dizzy, and weak immediately following the dose. The patient sought unspecified medical attention. Subsequently, the patient recovered on 11-DEC-2006. The patient''s experience did not prevent her from receiving the third vaccination. Additional information has been requested.

VAERS ID:284137 (history)  Vaccinated:2007-05-09
Age:14.0  Onset:2007-05-09, Days after vaccination: 0
Gender:Female  Submitted:2007-06-14, Days after onset: 36
Location:Pennsylvania  Entered:2007-06-18, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data:
CDC 'Split Type': WAES0705USA03181
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  UNUN
Administered by: Private     Purchased by: Other
Symptoms: Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: Information has been received from a physician concerning a 14 year old female who on 09-MAY-2007 was vaccinated with the first dose of Gardasil. Concomitant medication was not reported. On 09-MAY-2007 after the patient received her first dose of Gardasil, she "passed out". Subsequently on an unspecified date, the patient recovered from "passed out". Additional information has been requested.

VAERS ID:284145 (history)  Vaccinated:2007-05-01
Age:14.0  Onset:2007-05-01, Days after vaccination: 0
Gender:Female  Submitted:2007-06-14, Days after onset: 44
Location:New York  Entered:2007-06-18, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Reaction to sulphite; Milk allergy; Sulfonamide; Drug hypersensitivity; Polycystic ovarian syndrome
Preexisting Conditions: Unknown
Diagnostic Lab Data: Total heartbeat count, 05/01/2007, 46; Total heartbeat count, 05/01/07, 68.
CDC 'Split Type': WAES0705USA03385
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0387U1UNUN
Administered by: Private     Purchased by: Other
Symptoms: Loss of consciousness, Muscle twitching, Paraesthesia
SMQs:, Torsade de pointes/QT prolongation (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dyskinesia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: Information has been received from a physician concerning a 14 year old female who was vaccinated with a second dose of Gardasil. Subsequently the patient experienced tingling in her nose, passed out and little twitching. Unspecified medical attention was sought. It was reported that the patient recovered 2 minutes after the vaccine was administered. There were no diagnostic or laboratory tests performed. Additional information has been requested. This is in follow-up to reports previously submitted on 6/14/2007. Initial and follow-up information has been received from a physician concerning a 14 year old female stundent with reaction to sulphite, milk allergy, sulfonamide allergy, drug hypersensitivity to CECLOR and polycystic ovarin syndrome who on 01-MAY-2007 was vaccinated, into left arm, with a second dose og GARDASIL. On 01-MAY-2007, within 1 minute, the patient recovered from all symptoms and her heart rate was 68. There were no diagnostic or laboratory test performed. No further information is available.

VAERS ID:284156 (history)  Vaccinated:2007-05-17
Age:14.0  Onset:2007-05-17, Days after vaccination: 0
Gender:Female  Submitted:2007-06-14, Days after onset: 28
Location:Pennsylvania  Entered:2007-06-18, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type': WAES0705USA03778
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0IMUN
Administered by: Other     Purchased by: Other
Symptoms: Immediate post-injection reaction, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow)
Write-up: Information has been received from a physician concerning a 14 year old female patient with no known allergies who on 17-MAY-2007 was vaccinated IM with 0.5 ml of Gardasil. That same day, 5 minutes after the injection, she felt nauseous which lasted throughout the night and on 18-MAY-2007 she vomited. The patient sought unspecified medical attention. No further information is available. Additional information has been requested.

VAERS ID:284163 (history)  Vaccinated:2007-05-19
Age:14.0  Onset:2007-05-19, Days after vaccination: 0
Gender:Female  Submitted:2007-06-14, Days after onset: 26
Location:Pennsylvania  Entered:2007-06-18, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: blood pressure, 05/19/07, 110/70; total heartbeat count, 05/19/07, 72
CDC 'Split Type': WAES0705USA03876
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0IMUN
Administered by: Other     Purchased by: Other
Symptoms: Blood pressure, Heart rate, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Information has been received from a physician concerning a 14 year old female who on 19-MAY-2007 was vaccinated with the 1st dose Gardasil. There was no concomitant medication nor pertinent medical history. Subsequently the patient experienced syncopal episode within 5 minutes. Blood pressure was 110/70 and pulse rate was 72. Unspecified medical attention was sought and no treatment was required. Subsequently, the patient recovered from syncopal episode. Additional information has been requested.

VAERS ID:284166 (history)  Vaccinated:2007-05-01
Age:14.0  Onset:2007-05-01, Days after vaccination: 0
Gender:Female  Submitted:2007-06-14, Days after onset: 44
Location:California  Entered:2007-06-18, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown; None
Diagnostic Lab Data: ultrasound, pelvic ultrasound - normal
CDC 'Split Type': WAES0705USA03899
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0384U1IMUN
Administered by: Private     Purchased by: Private
Symptoms: Activities of daily living impaired, Pelvic pain, Ultrasound scan normal, Vaccine positive rechallenge
SMQs:, Dementia (broad)
Write-up: Information has been received from a physician concerning a 14 year old female patient who was vaccinated with 0.5ml first and second dose of Gardasil. Subsequently, the patient experienced pelvic pain to the point where she couldn''t get out of bed in the morning the day after receiving the vaccine. This happened with both the first and second shots. Unspecified medical attention was sought. Laboratory diagnostic studies included a sonogram. At the time of this report, the patient''s outcome was unknown. No product quality complaint was involved. Additional information has been requested. This is in follow-up to report(s) previously submitted on 6/14/2007. Information has been received from a licensed visiting nurse concerning a 14 year old female student with no medical history or allergies, who on 01-MAY-2007, was vaccinated IM with a second 0.5ml dose of GARDASIL (Lot# 657617/0384U). On 01-MAY-2007, the patient experienced pelvic pain to the point where she couldn''t get out of bed in the morning the day after receiving the vaccine. The patient was seen at her primary physicians office. Laboratory diagnostic studies included a pelvic ultrasound which was normal. On 03-MAY-2007, the patient recovered. It was also reported that the patient experienced pelvic pain after the first dose of GARDASIL. No product quality complaint was involved. Additional information is not expected.

VAERS ID:284489 (history)  Vaccinated:0000-00-00
Age:14.0  Onset:0000-00-00
Gender:Female  Submitted:2007-06-14
Location:Unknown  Entered:2007-06-18, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0705USA04961
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Information has been received from a physician concerning two females who were vaccinated with Gardasil. Subsequently the patients both developed fever and vomiting. Attempts are being made to obtain additional identifying information to distinguish the individual patients mentioned in this report. Additional information will be provided if available. Additional information has been requested. 07/06/07 This is in follow-up to report(s) previously submitted on 6/14/2007. Initial and follow up information has been received from a physician concerning two females who were vaccinated with GARDASIL. Subsequently the patients both developed fever and vomiting. Attempts are being made to obtain additional identifying information to distinguish the individual patients mentioned in this report. Additional information will be provided if available. In follow up, it was reported by the physician''s nurse that the patient was 14 years old and was vaccinated with her first dose of GARDASIL. The nurse was unsure how long the fever and vomiting lasted. Additional information has been requested.

VAERS ID:284494 (history)  Vaccinated:2007-05-21
Age:14.0  Onset:2007-05-21, Days after vaccination: 0
Gender:Female  Submitted:2007-06-14, Days after onset: 24
Location:Unknown  Entered:2007-06-18, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data:
CDC 'Split Type': WAES0705USA05147
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0522U1UNUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Hypoaesthesia, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: Information has been received from a physician concerning a 14 year old female who on 27-MAR-2007 was vaccinated with a first dose of Gardasil (lot not reported) and a second dose on 21-MAY-2007 (Lot# 657737/0522U). There were no concomitant medications. During this second injection on 21-MAY-2007 the patient experienced tingling and numbness in her arm immediately upon injection which continued for the rest of the day. It was her entire arm, but "not to the point of non-function". She needed no prescription treatment and subsequently recovered from tingling in arm and numbness in her arm. Additional information has been requested.

VAERS ID:284507 (history)  Vaccinated:0000-00-00
Age:14.0  Onset:0000-00-00
Gender:Female  Submitted:2007-06-14
Location:New York  Entered:2007-06-18, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0705USA05339
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0384U0IM 
Administered by: Private     Purchased by: Private
Symptoms: Dizziness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Initial information has been received from a physician and follow up information has been received from a nurse concerning a female patient between the ages of 11 and 19 who was vaccinated IM with a dose of Gardasil. It was reported that the patient sat for a minute (after receiving the injection) and when she got up to leave she fainted in the hallway. Her outcome was not reported. The physician reported that lot numbers were not available, however, the physician will forward other information including the lot numbers. Additional information has been requested.This is in follow-up to report (s) previously submitted on 6/14/2007. Follow-up information has been received from a healthcare professional concerning the 14 year old female student who on 26-Apr-2007 at 2:15 p.m. received her first IM dose of GARDASIL, LOT # 657617/0384u. At 2:15 p.m. the patient experienced dizziness (also reported as within 5 minutes of receiving immunization patient excperienced dizziness). The patient laid down on the exam table and was "within normal limits after 10 minutes on the table". No treatment was necessary. Addional information is not expected.

VAERS ID:284525 (history)  Vaccinated:2007-05-16
Age:14.0  Onset:2007-05-16, Days after vaccination: 0
Gender:Female  Submitted:2007-06-14, Days after onset: 29
Location:Ohio  Entered:2007-06-18, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0705USA05692
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0IMUN
Administered by: Private     Purchased by: Other
Symptoms: Pallor, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Information has been received from a registered nurse concerning a 14 year old female who "two weeks ago" on 16-MAY-2007 was vaccinated with her first dose of Gardasil 0.5 ml intramuscularly. After receiving the vaccination on 16-MAY-2007, the patient turned white, grabbed her mother''s arm and then fainted. Subsequently, the patient recovered. Additional information has been requested.

VAERS ID:284528 (history)  Vaccinated:0000-00-00
Age:14.0  Onset:2007-02-01
Gender:Female  Submitted:2007-06-14, Days after onset: 132
Location:Unknown  Entered:2007-06-18, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Asthma
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0705USA05702
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Frostbite, Hypoaesthesia, Skin discolouration
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Accidents and injuries (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: This is in follow-up to report(s) previously submitted on 6/14/2007. Information has been received from a Nurse Practitioner concerning a 14 year old female with no history of drug reactions/allergies and a history of asthma who on an unspecified date was vaccinated with Gardasil. Concomitant therapy included several other unspecified vaccines concomitantly and Necon. Subsequently on an unspecified date the patient developed frostbite of the toes/foot. The frostbite occurred some time in February in 40 degree weather outdoors at a football game with socks and shoes. The patient was still experiencing numbness and discoloration of toes. The vaccination was administered at another unspecified practice. The patient sought unspecified medical attention but did not undergo lab tests. As of 30-MAY-2007 the patient was recovering. Additional information has been requested. Further information is not available.

VAERS ID:284537 (history)  Vaccinated:2007-05-26
Age:14.0  Onset:2007-05-26, Days after vaccination: 0
Gender:Female  Submitted:2007-06-14, Days after onset: 19
Location:Arkansas  Entered:2007-06-18, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data:
CDC 'Split Type': WAES0705USA05737
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  IM 
Administered by: Other     Purchased by: Other
Symptoms: Dizziness, Hypotonia, Loss of consciousness, Malaise
SMQs:, Torsade de pointes/QT prolongation (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: Information has been received from a nurse concerning her 14 year old daughter who on 26-APR-2007 was vaccinated IM with 0.5 ml of Gardasil. On 26-MAY-2007 after she was vaccinated, the patient experienced dizziness and passed out. The patient sought unspecified medical attention. Subsequently, the patient recovered from the events. Additional information has been requested. In follow-up it was reported by the licensed practical nurse (LPN), concerning her white, 14 year old, student daughter, whose reported weight was 123 pounds and whose reported height was 65.2 inches who on 26-May-2007 was vaccinated intramuscularly (IM) with 0.5 ml of Gardasil (lot #657622/03880). It was reported that on 25-May-2007 after the patient received the Gardasil, the patient said that she didn''t feel very well and everything was black. She was assisted to a lying position and while she was getting ready to lie down she went limp and passed out for 3 minutes. Her name was called 2-3 times and she came "to". I t was reported thst the patient recovered. Additional information has been requested.

VAERS ID:282274 (history)  Vaccinated:2007-06-19
Age:14.0  Onset:2007-06-19, Days after vaccination: 0
Gender:Female  Submitted:2007-06-19, Days after onset: 0
Location:Pennsylvania  Entered:2007-06-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Hyperlipidemia and mild Scoliosis
Diagnostic Lab Data: BP 94/65 8:40 am taken again 94/61 8:50 am
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0522U1IMLA
Administered by: Private     Purchased by: Private
Symptoms: Blood pressure normal, Nausea, Paraesthesia, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Several minutes after IM injection with Gardasil vacc -patient felt nauseated and tingley. Fainted. Legs were elevated, BP taken, apple juice given. 10-15 minutes after later-felt better. Evaluated by doctor and was able to leave the office

VAERS ID:282279 (history)  Vaccinated:2007-06-14
Age:14.0  Onset:2007-06-16, Days after vaccination: 2
Gender:Male  Submitted:2007-06-19, Days after onset: 3
Location:New Jersey  Entered:2007-06-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Claritin
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data: CT scan, as above.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2327AA0IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC2632AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Computerised tomogram abnormal, Pain in jaw, Parotitis, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal infections (narrow), Osteonecrosis (broad), Hypersensitivity (narrow)
Write-up: Developed pain and swelling in left jaw area on 6/16/07; seen in ER, had CT scan done; diagnosed with left parotitis. Placed on po Augmentin for possible bacterial etiology; seen in office 6/19/07; slightly better.

VAERS ID:282596 (history)  Vaccinated:2007-06-07
Age:14.0  Onset:2007-06-19, Days after vaccination: 12
Gender:Female  Submitted:2007-06-21, Days after onset: 2
Location:Minnesota  Entered:2007-06-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none noted
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0389U0IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2323AA0IMLA
Administered by: Private     Purchased by: Other
Symptoms: Erythema, Joint swelling, Oedema peripheral, Pain, Tonsillitis, Urticaria
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Agranulocytosis (broad), Angioedema (narrow), Oropharyngeal infections (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad)
Write-up: 6/19/07 onset of urticaria , Left index finger swelling; 6/20/07 generalized urticaria, joint swelling of wrists/index finger, pain of coccyx, pain bilateral forearms with redness slight tonsil/ 6/21/07 swelling severe of hands, wrists, knees, increased urticara.

VAERS ID:282611 (history)  Vaccinated:0000-00-00
Age:14.0  Onset:0000-00-00
Gender:Female  Submitted:2007-06-21
Location:Connecticut  Entered:2007-06-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: CT head negative
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0524U0 LA
Administered by: Private     Purchased by: Unknown
Symptoms: Computerised tomogram normal, Convulsion, Head injury, Loss of consciousness, Syncope, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: Syncope head injury with loss of consciousness , questionable SZ, vomiting.

VAERS ID:282692 (history)  Vaccinated:2007-06-06
Age:14.0  Onset:2007-06-06, Days after vaccination: 0
Gender:Male  Submitted:2007-06-22, Days after onset: 16
Location:South Carolina  Entered:2007-06-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: peanuts
Diagnostic Lab Data: NONE
CDC 'Split Type': SC0708
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.0017U0IMRA
YF: YELLOW FEVER (YF-VAX)SANOFI PASTEURUF045AA5SCRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Cough, Eye pruritus, Injection site erythema, Injection site papule, Injection site pruritus, Throat irritation
SMQs:, Anaphylactic reaction (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad)
Write-up: 6/6/07: Administered yellow fever vaccine SQ and Hep A vaccine IM in right arm. Latex free bandaid applied to injection sites. Approximately 2 minutes later, patient complained of itching at both injection sites. Bandaids removed. At yellow fever site, small reddened papule formed which increased in size over the next 5 minutes. Patient complained of itching becoming worse. Also complained of itching of eyes and throat. Developed a cough that was not previously presnt. Benadryl 1 ml administered IM. Dr. in health department at the time of event and was called to clinic. Patient improved within 5 minutes. At 45 minutes, patient had no itching at injection site, no itching of throat or eyes. Patient breathing well, cough subsided. Patient discharged to care of parent. Vital signs stable. 6/7/07: Clinic nurse called patient and parent to inquire about symptoms. No sypmtoms. Patient feeling well.

VAERS ID:282771 (history)  Vaccinated:2007-01-16
Age:14.0  Onset:2007-01-16, Days after vaccination: 0
Gender:Female  Submitted:2007-06-18, Days after onset: 152
Location:New York  Entered:2007-06-25, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Albuterol M 02 prn
Current Illness: none
Preexisting Conditions: Asthma
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHANB124BA0IMRA
HPV4: HPV (GARDASIL)MERCK & CO. INC.0962F0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Vaccine positive rechallenge, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: Significant exacerbation of wheezing. Pt had 2nd HPV 6/12/07 - Merck 0587V. Similar symptoms.

VAERS ID:282772 (history)  Vaccinated:2007-06-12
Age:14.0  Onset:2007-06-12, Days after vaccination: 0
Gender:Female  Submitted:2007-06-19, Days after onset: 7
Location:Pennsylvania  Entered:2007-06-25, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Albuterol PRN, Zyrtec PRN
Current Illness: NONE
Preexisting Conditions: Environmental allergies
Diagnostic Lab Data: Patient also received Menactra vaccine same day 7/11/07-spoke with reporter''s office-patient became dizzy, fell in parking lot-returned to office BP 98/56. Appeared to be vasovagal reaction to immunization. Observed and recovered.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0955F0UNRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2004AA0UNRA
Administered by: Private     Purchased by: Private
Symptoms: Blood pressure decreased, Dizziness, Fall, Syncope vasovagal
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: None stated

VAERS ID:282875 (history)  Vaccinated:2007-06-13
Age:14.0  Onset:2007-06-14, Days after vaccination: 1
Gender:Female  Submitted:2007-06-19, Days after onset: 5
Location:New Mexico  Entered:2007-06-26, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0960F1IMRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0339U1SCLA
Administered by: Public     Purchased by: Public
Symptoms: Headache, Injection site erythema, Injection site pain, Injection site pruritus, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: On 6/13/07 client was given Gardasil and VAR vaccines at public health office. Family reports client began to have reaction to VAR on 6/14, came to this office 6/15 reporting pain, swelling, itching around site of Varicella vaccine (L) arm-This area, reddened, hot with swelling noted by nurse. They returned that afternoon, reaction somewhat larger, client had headache, itching arm pain. Referred to MD, began antibiotics that eve. soon improved. Resolved by 6/19/07.

VAERS ID:282895 (history)  Vaccinated:2007-04-10
Age:14.0  Onset:2007-04-10, Days after vaccination: 0
Gender:Female  Submitted:2007-06-26, Days after onset: 77
Location:Michigan  Entered:2007-06-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions:
Diagnostic Lab Data: none
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD)MERCK & CO. INC.0293U1SCRA
Administered by: Private     Purchased by: Private
Symptoms: No adverse effect
SMQs:
Write-up: none

VAERS ID:282913 (history)  Vaccinated:2007-06-14
Age:14.0  Onset:2007-06-14, Days after vaccination: 0
Gender:Female  Submitted:2007-06-26, Days after onset: 12
Location:Illinois  Entered:2007-06-27, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: diagnostic laboratory 06/15/07 - not diabetic, fasting blood glucose 06/15/07 176
CDC 'Split Type': WAES0706USA03415
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0IM 
Administered by: Other     Purchased by: Other
Symptoms: Blood glucose increased, Dizziness, Feeling abnormal, Hyperglycaemia, Lethargy
SMQs:, Hyperglycaemia/new onset diabetes mellitus (narrow), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad)
Write-up: Information has been received from a physician concerning a 14 year old female, with no pertinent medical history, who on 14-JUN-2007 was vaccinated IM, with a first dose of Gardasil (lot # "02630"). There was no concomitant medication. Approximately, on 14-JUN-2007 it was reported the patient was "light-headed", "out of it", and lethargic. On 15-JUN-2007 the patient had to be carried into the physicians office. Her sugar level was at 176 (hyperglycemic). She was tested for diabetes but it came back "negative". It was reported that by 16-JUN-2007 the patient "was feeling much better." The physician considered "light-headed", "out of it", lethargic, and a sugar level at 176 to be disabling. Additional information has been requested.

VAERS ID:283268 (history)  Vaccinated:2007-06-13
Age:14.0  Onset:2007-06-14, Days after vaccination: 1
Gender:Male  Submitted:2007-06-22, Days after onset: 8
Location:Illinois  Entered:2007-06-29, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC2834AA IMRA
Administered by: Private     Purchased by: Public
Symptoms: Burning sensation, Dizziness, Injection site pruritus, Nausea, Peripheral coldness, Pruritus, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: 6/14 Nausea, fever up to 102, feet felt like on fire "put in skillet". 6/15 C/O arms and neck burning. No tingling: feet cold with fever: dizziness; rash; itchy; dime size around site.

VAERS ID:283317 (history)  Vaccinated:2007-06-28
Age:14.0  Onset:2007-06-29, Days after vaccination: 1
Gender:Female  Submitted:2007-06-29, Days after onset: 0
Location:Illinois  Entered:2007-06-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Advil PRN after injection
Current Illness: WNL at exam
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (DAPTACEL)SANOFI PASTEURC2521AA  LA
Administered by: Private     Purchased by: Private
Symptoms: Body temperature increased, Dizziness, Headache, Injection site oedema, Pain, Wrong drug administered
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad)
Write-up: Patient was given Daptacel vs Adacel left deltoid in PM on 6/28/07. At 12:30p on 6/29/07 c/o 101 temp, arm pain, dizziness, frontal HA, slight edema at injection site.

VAERS ID:283549 (history)  Vaccinated:2007-06-21
Age:14.0  Onset:2007-06-21, Days after vaccination: 0
Gender:Male  Submitted:2007-06-26, Days after onset: 5
Location:Washington  Entered:2007-07-02, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ADDERALL
Current Illness: None
Preexisting Conditions: Hx ADHD on meds
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2170AA0IMLA
Administered by: Other     Purchased by: Public
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Hives on one arm 5-7 minutes after IM injection of Menactra. Treated with Benadryl 50mg oral x 1. No further issues.

VAERS ID:283566 (history)  Vaccinated:2007-06-11
Age:14.0  Onset:2007-06-11, Days after vaccination: 0
Gender:Male  Submitted:2007-06-24, Days after onset: 13
Location:New York  Entered:2007-07-02, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEUR    
Administered by: Private     Purchased by: Unknown
Symptoms: Pruritus, Rash generalised
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Two hours after having a MCV vaccine my son got rash all over his body (very small dots) and very itchy.

VAERS ID:283597 (history)  Vaccinated:2007-05-21
Age:14.0  Onset:2007-05-23, Days after vaccination: 2
Gender:Male  Submitted:2007-07-02, Days after onset: 40
Location:Ohio  Entered:2007-07-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Claritin, Singulair, Flonase
Current Illness: none
Preexisting Conditions: environmental allergies
Diagnostic Lab Data: none
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0305U1SCRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: 48 hours after administration of varicella vaccine (booster), pt seen in office for ~5cm area of erythema, warmth, swelling at site of injection

VAERS ID:283645 (history)  Vaccinated:0000-00-00
Age:14.0  Onset:0000-00-00
Gender:Female  Submitted:2007-07-02
Location:Pennsylvania  Entered:2007-07-03, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0706USA04875
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0524U UNUN
Administered by: Other     Purchased by: Other
Symptoms: Convulsion, Eye rolling, Loss of consciousness, Poor quality drug administered
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: Information has been received from a nurse concerning a 14 year old female who was vaccinated with the second dose of the Gardasil (Lot # 658094/0524U) on an unspecified date. It was reported that the patient experienced seizure like activity after receiving the vaccine. Her eyes rolled back in her head and briefly lost consciousness. The patient sought unspecified medical attention. She recovered 40 minutes after injection. The nurse also reported that the refrigerator where the vaccine was stored was "4 degrees colder than it should have been". Upon internal review, seizure-like activity was considered to be an other important medical event. This report is one of two reports from the same source. Additional information has been requested.

VAERS ID:283846 (history)  Vaccinated:2007-06-20
Age:14.0  Onset:2007-06-21, Days after vaccination: 1
Gender:Female  Submitted:2007-06-25, Days after onset: 4
Location:California  Entered:2007-07-05, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0522U0IMRA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B009AA5IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0534U1SCLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: 10-12 cm of erythema, mildly swollen and warm at site of Varicella injection

VAERS ID:283850 (history)  Vaccinated:2007-06-25
Age:14.0  Onset:2007-06-25, Days after vaccination: 0
Gender:Female  Submitted:2007-06-26, Days after onset: 1
Location:Michigan  Entered:2007-07-05, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0962F IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2139AA IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC2492BA IMRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0364U SCLA
Administered by: Private     Purchased by: Unknown
Symptoms: Deafness, Dizziness, Hyperhidrosis, Pallor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hearing impairment (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: After administering the HPV vaccine, the patient lost her hearing, became dizzy and broke out in a sweat, pale. I had to wait to give the rest of the vaccines. Patient laid down on exam table - drank some water and had cool cloth to the head. After 10 min - she was ok.

VAERS ID:283853 (history)  Vaccinated:2007-06-18
Age:14.0  Onset:2007-06-19, Days after vaccination: 1
Gender:Male  Submitted:2007-06-23, Days after onset: 4
Location:Texas  Entered:2007-07-05, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Cephalexin
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2328AA0IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURC2720AA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Axillary pain, Fatigue, Headache, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Fatigue, fever, headache, and Lt arm sore and tender left axillary lymph node which began 6/19/07. Severity moderate RX Cephalexin 500mg 1 TID x 7 days.

VAERS ID:284005 (history)  Vaccinated:2007-06-27
Age:14.0  Onset:2007-06-28, Days after vaccination: 1
Gender:Female  Submitted:2007-06-29, Days after onset: 1
Location:California  Entered:2007-07-06, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0469U IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC2731AA IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0644U SCLA
Administered by: Private     Purchased by: Unknown
Symptoms: Injection site pruritus, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pt states she noticed arm swelling (L) arm 6/28/07 in the evening w/slight itching

VAERS ID:284013 (history)  Vaccinated:2007-06-25
Age:14.0  Onset:2007-06-28, Days after vaccination: 3
Gender:Female  Submitted:2007-07-06, Days after onset: 8
Location:New York  Entered:2007-07-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0524U0IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0644U1SCRA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Tenderness
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Red, hard, tender over right tricep --$g 4-5cm diameter. Reassurance ice pack/ Motrin.

VAERS ID:284205 (history)  Vaccinated:2007-07-09
Age:14.0  Onset:2007-07-09, Days after vaccination: 0
Gender:Female  Submitted:2007-07-09, Days after onset: 0
Location:North Carolina  Entered:2007-07-10, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: None
CDC 'Split Type': NC07075
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0181U1UNLA
Administered by: Private     Purchased by: Private
Symptoms: Syncope, Tremor, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Within 5 sec after giving shot, child started shaking, unresponsive for 15-30 sec then fainted.

VAERS ID:284300 (history)  Vaccinated:2007-07-09
Age:14.0  Onset:2007-07-11, Days after vaccination: 2
Gender:Male  Submitted:2007-07-11, Days after onset: 0
Location:Arizona  Entered:2007-07-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: none~ ()~NULL~~In Patient
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: N/A
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2230AA0IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0718U1SCRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Injection site is swollen, red, warm to touch, slightly itchy.

VAERS ID:284330 (history)  Vaccinated:2006-12-29
Age:14.0  Onset:2006-12-29, Days after vaccination: 0
Gender:Female  Submitted:2007-06-30, Days after onset: 182
Location:Ohio  Entered:2007-07-11, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2312AA IMRA
HEPA: HEP A (VAQTA)MERCK & CO. INC.1008F IMLA
HPV4: HPV (GARDASIL)MERCK & CO. INC.1425F IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site bruising, Injection site swelling, Pyrexia
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Fever - 12/29/06, bruising at the injection site 12/30/06, swelling approximately golf size at the injection site - 12/30/06.

VAERS ID:284334 (history)  Vaccinated:2007-07-10
Age:14.0  Onset:2007-07-11, Days after vaccination: 1
Gender:Female  Submitted:2007-07-11, Days after onset: 0
Location:Pennsylvania  Entered:2007-07-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Known
Preexisting Conditions: Acne - currently using Niacin and Differin
Diagnostic Lab Data: Rapid strep - negative; Throat cultures sent 7/11/07
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB172BA0IMLA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B018BA0IMRA
Administered by: Private     Purchased by: Private
Symptoms: Body temperature increased, Culture throat, Dizziness, Dry mouth, Headache, Nausea, Streptococcus identification test negative
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: Woke up 7/11/07 with increased temp 101.4, c/o H/A, nausea, dry mouth, dizziness

VAERS ID:284361 (history)  Vaccinated:2007-06-29
Age:14.0  Onset:2007-07-01, Days after vaccination: 2
Gender:Female  Submitted:2007-07-02, Days after onset: 1
Location:Virginia  Entered:2007-07-11, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0718U1SC 
Administered by: Private     Purchased by: Private
Symptoms: Cellulitis
SMQs:
Write-up: Seen in ER on 7/1/07 diagnosed with cellulitis.

VAERS ID:284384 (history)  Vaccinated:2007-06-20
Age:14.0  Onset:2007-06-22, Days after vaccination: 2
Gender:Female  Submitted:2007-07-11, Days after onset: 19
Location:Texas  Entered:2007-07-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB162DA1UNRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 1SCLA
Administered by: Private     Purchased by: Unknown
Symptoms: Erythema, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Right arm, red swollen - Keflex and Benadryl

VAERS ID:284401 (history)  Vaccinated:2007-07-09
Age:14.0  Onset:2007-07-09, Days after vaccination: 0
Gender:Female  Submitted:2007-07-09, Days after onset: 0
Location:Kansas  Entered:2007-07-12, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1427F0IMLA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC528009AA5IMRA
Administered by: Private     Purchased by: Unknown
Symptoms: Blood pressure decreased, Nausea, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Fainted/nausea/decreased BP - Trendelenberg used. Unable to get a B/P but pt was alert. B/P after 10 min was 100/58 (normal per pt)

VAERS ID:284893 (history)  Vaccinated:2007-04-02
Age:14.0  Onset:2007-04-02, Days after vaccination: 0
Gender:Female  Submitted:2007-07-06, Days after onset: 95
Location:Oklahoma  Entered:2007-07-13, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Penicillin allergy
Preexisting Conditions:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0704USA02535
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1426F0IMUN
Administered by: Private     Purchased by: Public
Symptoms: Eye pruritus, Eye swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Initial and follow up information has been received from a physician concerning a 14 year old female student with possible penicillin allergy who on 02-APR-2007 was vaccinated IM with a first dose 0.5 mL of Gardasil lot # 655205/1426F. On 02-APR-2007 the patient developed swollen eyes after receiving the injection. On 03-APR-2007 the patient was seen in the emergency room (E.R.) for swollen eyes and itching and was given BENADRYL intravenous (IV) and ATERAX by mouth (PO). No abnormality of the eye found. On 05-APR-2007 the patient recovered. In follow up it was indicated that on 03-APR-2007, at AM patient developed swollen eyes and itching. She was seen in the emergency room (E.R.) on 03 APR-2007 and no abnormality of the eyes found. She was given treatment of BENADRYL intravenous (IV) and ATERAX by mouth. On 05-APR-2007 patient recovered. Additional information is not expected.

VAERS ID:284911 (history)  Vaccinated:2007-05-31
Age:14.0  Onset:2007-05-31, Days after vaccination: 0
Gender:Female  Submitted:2007-07-06, Days after onset: 36
Location:Arizona  Entered:2007-07-13, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0706USA00556
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0522U0UNUN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEUR  UNUN
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0516U UNUN
Administered by: Other     Purchased by: Other
Symptoms: Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: Information has been received from a physician, via a company representative, concerning a 14 year old female patient, who on 31-MAY-2007 was vaccinated with the first dose of Gardasil (Lot #657737/0522U). Concomitant therapy included Varivax (MSD) (Lot 657406/0516U) and MENACTRA. The physician reported that on 31-MAY-2007, the patient passed out after receiving the vaccination, and recovered on the same day (duration of time not specified). The patient sought unspecified medical attention. Additional information has been requested. Initial and follow up information has been received from a physician and a healthcare professional, concerning a 14 year old, female student, with no significant medical history and no known allergies, who on 31-MAY-2007, at 3:00pm was vaccinated IM, with the first dose of GARDASIL (lot #657737/0522U). Concomitant therapy included VARICELLA virus vaccine live (lot 657406/0516U) and MENACTRA. There was no illness at the time of vaccination. The physician reported that on 31-MAY-2007, the patient passed out, and recovered on the same day.

VAERS ID:284915 (history)  Vaccinated:2007-06-04
Age:14.0  Onset:2007-06-04, Days after vaccination: 0
Gender:Female  Submitted:2007-07-06, Days after onset: 32
Location:Arizona  Entered:2007-07-13, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: None
CDC 'Split Type': WAES0706USA00639
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.  UNUN
HPV4: HPV (GARDASIL)MERCK & CO. INC.  IMUN
Administered by: Private     Purchased by: Private
Symptoms: Loss of consciousness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: Information has been received from a physician concerning a 14 year old white female with no pertinent medical history or drug reactions/allergies who on 04-JUN-2007 was vaccinated with first dose of Gardasil ( lot # 656050/0245U) IM at 11AM. Concomitant therapy included Vaqta (manufacturer unknown). On 04-JUN-2007, the physician reported that the patient experienced passed out after receiving Gardasil. The patient sought unspecified medical attention. On 04-JUN-2007, the patient recovered from having passed out. Additional information was received from a health professional. The patient had no illness at the time of vaccination. The patient experienced syncope on 04-JUN-207 at 11:10AM. Further information is not available.

VAERS ID:285048 (history)  Vaccinated:2007-03-21
Age:14.0  Onset:0000-00-00
Gender:Female  Submitted:2007-07-06
Location:Maine  Entered:2007-07-13, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0706USA01160
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 2UNUN
Administered by: Other     Purchased by: Other
Symptoms: Menstruation delayed
SMQs:, Fertility disorders (broad)
Write-up: Information has been received from a nurse practitioner concerning a 14 year old female who on 21-MAR-2007 was vaccinated with a third dose of Gardasil. Subsequently the patient experienced a skipped menstrual period in April and May (but had slight spotting in May). Unspecified medical attention was sought. A pregnancy test was not given to the patient. This is one of two reports received from the same source. Additional information has been requested.

VAERS ID:284780 (history)  Vaccinated:2007-06-26
Age:14.0  Onset:2007-06-26, Days after vaccination: 0
Gender:Female  Submitted:2007-07-12, Days after onset: 16
Location:Iowa  Entered:2007-07-16, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  UNUN
Administered by: Public     Purchased by: Other
Symptoms: Mydriasis, Pallor, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Pt fainted with-in one minute after receiving Gardasil. Her eyes had dilated pupils and her color was pale. She was quickly placed supine. Mother stated she woke her up and brought her in. She had not eaten or had fluids that morning. She was talking after being placed supine and had completely recovered 3 min later.

VAERS ID:284862 (history)  Vaccinated:2007-02-27
Age:14.0  Onset:2007-03-01, Days after vaccination: 2
Gender:Female  Submitted:2007-07-06, Days after onset: 126
Location:Pennsylvania  Entered:2007-07-17, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Possible early glaucoma
Diagnostic Lab Data: All labs for arthritis/SLE negative per rheumatology
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0187U0UNUN
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Pyrexia, Rheumatoid factor negative
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arthritis (broad)
Write-up: Arthralgias (in knees/ankles/feet i.e small jts) finges/toeswrist, Fever Sx approx. 2-3 days after Gardasil

VAERS ID:284962 (history)  Vaccinated:2007-07-10
Age:14.0  Onset:2007-07-13, Days after vaccination: 3
Gender:Female  Submitted:2007-07-17, Days after onset: 4
Location:Alabama  Entered:2007-07-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: hospilization surgery fever swelling
Preexisting Conditions: None. PMH: Cellulitis after 1st injection.
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0384U2UNRL
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site induration, Local reaction, Pain, Pyrexia, Surgery, Swelling, Tenderness, Vaccine positive rechallenge
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: 1st shot 3 days later swelling, fever, in right arm & breast next week later surgery 2 month later had nurse to put in opposite arm swelling reaction from neck down on left side lots of pain no one told us of these side affects. 8/13/2007 MR received for ER visit 7/17/2007 for c/o swelling and tenderness in L deltoid. PE (+) minimal induration at injection site and tenderness to palpation of the L back. DX: Local reaction to vaccination.

VAERS ID:284970 (history)  Vaccinated:2007-07-06
Age:14.0  Onset:2007-07-16, Days after vaccination: 10
Gender:Female  Submitted:2007-07-17, Days after onset: 1
Location:California  Entered:2007-07-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: CBC Herpes H2 Mono Aso Chem Sed Rate
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1427E1IMRA
Administered by: Private     Purchased by: Public
Symptoms: Erythema multiforme, Full blood count, Haematocrit, Haemoglobin, Herpes simplex serology, Laboratory test, Mononucleosis heterophile test, Red blood cell sedimentation rate
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow)
Write-up: Erythema Multiforme 12 days post Gardasil vaccine. Eruptions started on 10 day post vaccine

VAERS ID:284977 (history)  Vaccinated:2007-07-06
Age:14.0  Onset:2007-07-08, Days after vaccination: 2
Gender:Male  Submitted:2007-07-09, Days after onset: 1
Location:Texas  Entered:2007-07-17, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamin
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0601U1SCUN
Administered by: Private     Purchased by: Private
Symptoms: Cellulitis, Erythema, Pyrexia, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Pt with swollen, red and feverish arm to the outer 1/3 of subcutaneous tissue on (R) upper arm. Pt received Varicella (SQ) (R) arm 7-6- noticed elevation in swelling and erythema over past 3 days. Pt seen in office on 7/9 to r/o cellulitis.

VAERS ID:285413 (history)  Vaccinated:0000-00-00
Age:14.0  Onset:2007-04-01
Gender:Female  Submitted:2007-07-16, Days after onset: 106
Location:New York  Entered:2007-07-18, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0706USA02148
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0UNUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Information has been received from a physician concerning a female who was vaccinated with the first dose of Gardasil. Subsequently the patient was at the front desk to make another appointment when she fainted. Medical attention was sought. Additional information has been requested. Information has been received from a physician concerning a 14 year old female student who was vaccinated with a first dose of GARDASIL. On 11-APR-2007, the patient fainted a few minutes after receiving the vaccine. The physician had her lie down and took her blood pressure which was 98/60. The patient was watched for 10 to 15 minutes and then she went home. It was reported that there was no nausea or vomiting. On 11-APR-2007, the patient recovered. No product quality complaint was involved. Additional information is not expected.

VAERS ID:285470 (history)  Vaccinated:2007-04-19
Age:14.0  Onset:2007-04-19, Days after vaccination: 0
Gender:Female  Submitted:2007-07-16, Days after onset: 88
Location:Pennsylvania  Entered:2007-07-18, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0706USA03039
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0637F0UNUN
Administered by: Other     Purchased by: Other
Symptoms: Abdominal pain, Dysmenorrhoea, Vaccine positive rechallenge
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Information has been received from a immunization coordinator concerning a female who was vaccinated with a first dose of Gardasil. Subsequently after the first dose the patient experienced abdominal cramping similar to menstrual cramps. Unspecified medical attention was sought. Subsequently, the patient recovered from the abdominal cramping similar to menstrual cramps. The patient was vaccinated with a second dose of Gardasil. Subsequently after the second dose the patient experienced abdominal cramping similar to menstrual cramps. Unspecified medical attention was sought. Subsequently, the patient recovered from the abdominal cramping similar to menstrual cramps. Additional information has been requested. 10/08/07 This is in follow-up to report(s) previously submitted on 7/16/2007. Initial information has been received from an immunization coordinator concerning a 14 year old female who on 19-APR-2007, at 1:30 pm was vaccinated with a first dose of GARDASIL (lot # 653937/0637F). On 19-APR-2007 one hour after the first dose the patient experienced lower abdominal cramping similar to menstrual cramps. No treatment was required. Subsequently, the patient recovered from the lower abdominal cramping similar to menstrual cramps after 48 hours. On 14-JUN-2007 the patient was vaccinated with a second dose of GARDASIL (lot # 657006/0188U). On 14-JUN-2007, one hour after vaccination after the second dose the patient experienced lower abdominal cramping similar to menstrual cramps. Subsequently, the patient recovered from the lower abdominal cramping similar to menstrual cramps after 48 hours. No treatment was required. Additional information is not expected.

VAERS ID:285668 (history)  Vaccinated:2007-04-24
Age:14.0  Onset:2007-04-24, Days after vaccination: 0
Gender:Female  Submitted:2007-07-16, Days after onset: 83
Location:Pennsylvania  Entered:2007-07-18, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0706USA03900
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0384U2UNLA
Administered by: Private     Purchased by: Other
Symptoms: Injection site urticaria
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Initial and follow-up information has been received from a physician and a healthcare professional concerning a 14 year old female who on 24-APR-2007, at 15:30, was vaccinated in her left arm with the third dose of GARDASIL vaccine (lot #4657617/0384U). Subsequently, during the evening after vaccination, on 24-APR-2007, at 2:00, the patient developed a half-dollar, raised welt at the injection site. The patient sought unspecified medical attention. It was reported that the welt lasted for two days. Additional information has been requested. This is in follow-up to report (s) previously submitted on 7/16/2007. On 25-APR-2007, the following day, the patient was recovered. No additional information is expected.

VAERS ID:285842 (history)  Vaccinated:2007-05-17
Age:14.0  Onset:2007-05-17, Days after vaccination: 0
Gender:Female  Submitted:2007-07-16, Days after onset: 60
Location:Oklahoma  Entered:2007-07-18, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0706USA04705
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0IM 
Administered by: Other     Purchased by: Other
Symptoms: Dizziness, Immediate post-injection reaction
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: Information has been received from a physician concerning a 14 year old female who on 17-MAY-2007 was vaccinated with her first dose of Gardasil IM. The physician reported that the patient felt dizzy right after receiving the first dose of Gardasil IM. At the time of reporting the patient recovered from feeling dizzy and no further information was provided. Additional information has been requested.

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