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Case Details (Sorted by Age)

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VAERS ID:270531 (history)  Vaccinated:2006-12-19
Age:17.0  Onset:2006-12-19, Days after vaccination: 0
Gender:Female  Submitted:2007-01-12, Days after onset: 24
Location:Unknown  Entered:2007-01-16, 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:
Preexisting Conditions:
Diagnostic Lab Data: Blood pressure, 12/19/06: 90/60; Blood glucose, 12/19/06: normal; Total heartbeat count, 12/19/06: 62
CDC 'Split Type': WAES0701USA00376
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0955F0 UN
Administered by: Private     Purchased by: Other
Symptoms: Blood pressure decreased, Convulsion, Crying, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (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), Depression (excl suicide and self injury) (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: Information has been received from the mother of a 17 year old female patient with acne and pertinent medical history and drug reactions/allergies reported as none who on 19-DEC-2006 was vaccinated with an initial dose of Gardasil, injection in the left upper arm. Concomitant therapy included sulfamethoxazole/trimethoprim. On 19-DEC-2006, the patient experienced two seizures after receiving the Gardasil vaccine. The patient''s mother reported that the patient "blacked out" about one to two minutes after receiving the injection and was unconscious for about a minute before she experienced the first seizure. The patient had felt nauseous when she had regained consciousness. The patient''s mother then reported that the patient "blacked out again" and had the second seizure which was more "severe". When the patient came out of it she started crying. The patient''s mother reported that the physician kept them at the office for about three hours to watch her and she was given water. The patient was instructed to see a neurologist. Subsequently at the time of this report, the patient recovered from seizures. Seizures was considered to be an other important medical event (OMIC). Additional information has been requested.

VAERS ID:270611 (history)  Vaccinated:2007-01-03
Age:17.0  Onset:2007-01-04, Days after vaccination: 1
Gender:Female  Submitted:2007-01-09, Days after onset: 5
Location:Missouri  Entered:2007-01-17, 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: Birth control
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0961F0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Flushing, Malaise, Skin warm, Somnolence, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad)
Write-up: 01/04/07 pt started getting sick around 2pm, her face was warm and flush, no recorded fever, threw up one time. Fell asleep until 5pm woke up ate a little dinner went back to sleep until next morning.

VAERS ID:270627 (history)  Vaccinated:2007-01-10
Age:17.0  Onset:2007-01-10, Days after vaccination: 0
Gender:Female  Submitted:2007-01-17, Days after onset: 7
Location:North Dakota  Entered:2007-01-17
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 identified
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.10221IMRA
Administered by: Public     Purchased by: Public
Symptoms: Medication error
SMQs:
Write-up: Given an Adult dose of Hepatitis B rather than the pediatric formulation. No adverse effects have been noted. CDC was notified and this nurse was told to fill this out per their request since an adolescent received an adult dose instead a pediatric one.

VAERS ID:271101 (history)  Vaccinated:2006-10-16
Age:17.0  Onset:2006-10-16, Days after vaccination: 0
Gender:Female  Submitted:2007-01-16, Days after onset: 92
Location:Michigan  Entered:2007-01-22, 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:
Current Illness: Pregnancy NOS (LMP = 9/11/2006); Gastrooesophageal reflux; Dyspepsia
Preexisting Conditions:
Diagnostic Lab Data: ultrasound 12/19/06 - gest age 24.7 weeks, beta-human chorionic 10/31/06 - positive ; diagnostic laboratory, "CF Carrier Screen" Negative
CDC 'Split Type': WAES0612USA01297
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0688F0IM 
Administered by: Other     Purchased by: Other
Symptoms: Blood human chorionic gonadotropin positive, Drug exposure during pregnancy, Laboratory test abnormal, Pregnancy test positive, Ultrasound abdomen abnormal, Ultrasound uterus, Vaginitis bacterial
SMQs:, Retroperitoneal fibrosis (broad), Tumour markers (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Normal pregnancy conditions and outcomes (narrow)
Write-up: This is in follow-up to report(s) previously submitted on 1/16/2007. Initial and follow-up information has been received from a physician through the Merck pregnancy registry concerning a 17 year old female with episodic reflux and dyspepsia and no known drug allergies and no previous pregnancies who on 16-Oct-2006 was vaccinated intramuscularly with the first dose of GARDASIL (0.5 ml) (lot # 653735/0688F). Concomitant therapy included PRILOSEC OTC and prenatal vitamins. From 20-Oct-2006 to 26-Oct-2006 the patient was placed on therapy with FLAGYL 500 mg twice daily for bacterial vaginitis. On 31-Oct-2006 the patient was found to have a positive pregnancy test. LMP was 11-Sep-2006. Unspecified medical attention was sought and the patient was placed on prenatal vitamins. On 19-Dec-2006, an ultrasound revealed gestational age 24.7 weeks which was not consistent with the estimated date of last menstrual period (LMP). On an unspecified date a Cystic Fibrosis carrier screen was performed, results were negative. On 22-MAR-2007 she delivered a normal, healthy male baby weighing 6 pounds 3 ounces and 18 1/2" long, with a head circumference of 33.5 cm, and APGAR scores of 9 at one and five minutes. The patient''s labor and delivery was uncomplicated. No other symptoms were noted. At the time of this report, the outcome of the events was unknown. Additional information has been requested.

VAERS ID:271105 (history)  Vaccinated:2006-12-13
Age:17.0  Onset:2006-12-13, Days after vaccination: 0
Gender:Female  Submitted:2007-01-16, Days after onset: 34
Location:Maryland  Entered:2007-01-22, 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:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: vital sign 12/13/06 - normal
CDC 'Split Type': WAES0612USA02247
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0961F0IMLA
Administered by: Other     Purchased by: Other
Symptoms: Hyperhidrosis, Hypotension, Immediate post-injection reaction, Pallor, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow)
Write-up: Information has been received from a registered nurse concerning a female patient who on 13-Dec-2006 was vaccinated intramuscularly in the left deltoid with the first dose of Gardasil vaccine (yeast) (0.5 ml) (lot#654389/0961F). There was no concomitant medication. On 13-Dec-2006, shortly after vaccination, the patient fainted and her skin color was pale. The patient was aroused by shaking her right arm and with smelling salts. The patient''s vital signs were found to be normal upon discharge from the office. No further details were provided. Additional information has been requested. This is in follow-up to report(s) previously submitted on 1/16/2007. Follow up information received from the physician stated that on 13-DEC-2006 the injection of GARDASIL was administered by a medical assistant. It was reported that immediately after receiving the vaccination the patient had a syncopal episode. It was reported that the patient became hypotensive (actual blood pressure measurement not provided) and diaphoretic and responded to ammonia salts, being placed in the Trendelenburg and hydration, taken by mouth. It was reported that patient recovered from the event. Additional information has been requested.

VAERS ID:271114 (history)  Vaccinated:2006-11-30
Age:17.0  Onset:2006-11-30, Days after vaccination: 0
Gender:Female  Submitted:2007-01-16, Days after onset: 47
Location:Vermont  Entered:2007-01-22, 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:
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0612USA02571
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  IM 
Administered by: Other     Purchased by: Other
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Information has been received from a nurse practitioner concerning a 17 year old female with no medical history or allergies, who on 30-Nov-2006 was vaccinated IM with a 0.5 ml dose of Gardasil vaccine (yeast). Concomitant therapy included an unspecified hormonal contraceptives (unspecified). On 30-Nov-2006, the patient experienced severe injection site pain. Unspecified medical attention was sought. No diagnostic laboratory studies were performed. Subsequently, the patient recovered. No product quality complaint was involved. Additional information has been requested.

VAERS ID:271138 (history)  Vaccinated:0000-00-00
Age:17.0  Onset:0000-00-00
Gender:Female  Submitted:2007-01-16
Location:Unknown  Entered:2007-01-22, 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:
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC 'Split Type': WAES0612USA03315
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  IM 
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 an office manager concerning a 17 year old female patient who on an unspecified date was vaccinated with HPV rL1 6 11 16 18 VLP vaccine (yeast), 0.5 mL, injection. concomitant medication was not reported. Subsequently on an unspecified date, the patient fainted after she received the first dose of HPV rL1 6 11 16 18 VLP vaccine (yeast). The patient sough unspecified medical attention. The office manager stated that the patient did not have anything to eat prior to receiving the injection. Subsequently on an unspecified date, the patient recovered from the event. Additional information has been requested.

VAERS ID:271160 (history)  Vaccinated:2006-12-04
Age:17.0  Onset:2006-12-05, Days after vaccination: 1
Gender:Female  Submitted:2007-01-16, Days after onset: 42
Location:New Jersey  Entered:2007-01-22, 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: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0701USA00115
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0868F1IMLA
Administered by: Other     Purchased by: Other
Symptoms: Rash pruritic
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Information has been received from an office manager concerning a 16 year old female who on 04 Dec 2006 was vaccinated IM, into the left deltoid, with 0.5 ml second dose of Gardasil (lot #653736/0868F). On 05 Dec 2006 the patient developed an itchy rash on her arm. The patient was treated with Benadryl and the rash was gone the on the night of 05 Dec 2006. On 06 Dec 2006, the patient recovered. The office manger reported that there was no adverse reaction after the patient''s first dose of Gardasil. Additional information has been requested.

VAERS ID:270982 (history)  Vaccinated:2006-08-14
Age:17.0  Onset:2006-09-04, Days after vaccination: 21
Gender:Female  Submitted:2007-01-23, Days after onset: 141
Location:Minnesota  Entered:2007-01-23
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: Amoxicillin (rash); acne; Hx of depression Zoloft
Diagnostic Lab Data: Clinical diagnosis of Bell''s palsy, abnormal brain MRI findings consistent with Bell''s palsy. CBC, normal Thyroid normal per family Lyme titer negative. MRI showed nonspecific white matter changes not consistent with a demyelinating process.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU1874AA IM 
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSC245AA IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Ageusia, Ear pain, Facial palsy, Headache, Nuclear magnetic resonance imaging abnormal
SMQs:, Taste and smell disorders (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad)
Write-up: Bell''s palsy developed within 21 days of vaccine administration 01/30/07-records received and reviewed from MD for DOS 11/3/06. DX: Bell''s Palsy. 9/3/06-complaint of ear ache and headache, 9/4/06 headache and weak face. Seen in ER treated with prednisone and Famvir for one week. Over time shown some recovery. Decreased tearing, has lost her taste on the left part of the tongue and that has returned. Has had some but not complete recovery of movement in her left face. Difficult for her to smile completely difficulty with blinking. Does not completely close her eyes at night uses artificial tears during day. No pain in face. Diffuse nondescript headaches occur more frequently. Current medications: Zoloft, does get dizzy at times. Fainted a couple of weeks ago. EKG normal.

VAERS ID:271096 (history)  Vaccinated:2007-01-10
Age:17.0  Onset:2007-01-10, Days after vaccination: 0
Gender:Female  Submitted:2007-01-20, Days after onset: 10
Location:Texas  Entered:2007-01-25, 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0  
Administered by: Private     Purchased by: Private
Symptoms: Blood pressure decreased, Disorientation, Fall, 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), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: Shortly after administration of vaccine, patient loss consciousness, fell from exam table to floor. Was out for 2-3 minutes, was very disoriented and seemed to have difficult time waking. Blood pressure was checked about 5 minutes later when move back to table. Had dropped from initial measurement of 100/70 to 80/40-patient rested for approximately 30 minutes and pressure went back up to 90/70. Patient allowed to leave. Patient has no history of any reactions to injections.

VAERS ID:271188 (history)  Vaccinated:2007-01-22
Age:17.0  Onset:2007-01-24, Days after vaccination: 2
Gender:Male  Submitted:2007-01-25, Days after onset: 1
Location:Unknown  Entered:2007-01-25
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: influenza test - negative 1/24/07
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2215AA0IMLA
HEPA: HEP A (VAQTA)MERCK & CO. INC.1209F0IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2116AA0IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dizziness, Feeling cold, Headache, Influenza serology negative, Nasal mucosal discolouration, Pain, Rhinorrhoea
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)
Write-up: Patient had well child exam 1/22/07, received Influenza vaccine, Hepatitis A, Menactra. 1/24/07 patient returned to clinic with complaints of dizziness, headache, chill, green/yellow nasal drainage, bodyaches. Sites free from any s/s of infection or irritation/ VSS no temp. Patien informed by PA-C to increase fluids, take tylenol/motrin for the bodyaches, RTC if sx increase or any other complication arise.

VAERS ID:271429 (history)  Vaccinated:2007-01-29
Age:17.0  Onset:0000-00-00
Gender:Male  Submitted:2007-01-29
Location:Minnesota  Entered:2007-01-29
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
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU1637AA0 LA
TDAP: TDAP (ADACEL)AVENTIS PASTEURC2631AA0 RA
Administered by: Other     Purchased by: Other
Symptoms: Wrong drug administered
SMQs:
Write-up: Patient was given Td in Left arm and Tdap in Right arm mistakenly. (was suppose to receive Tdap and HBV#2).

VAERS ID:271502 (history)  Vaccinated:2007-01-15
Age:17.0  Onset:2007-01-18, Days after vaccination: 3
Gender:Male  Submitted:2007-01-25, Days after onset: 7
Location:Wisconsin  Entered:2007-01-30, 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: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0862F1SCLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU1908AA0IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURC2609AA0IMRA
Administered by: Other     Purchased by: Public
Symptoms: Erythema, Feeling hot, Pain, Skin discolouration, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad)
Write-up: Erythema, warmth, swelling, pain. Measured 15cm x 17cm pink and swelling on 1/23/07 gives history of having pertussis disease 2 yrs ago. Follow-up states - MMR II vaccine lot number actually 0862F. Record updated.

VAERS ID:271532 (history)  Vaccinated:2007-01-16
Age:17.0  Onset:2007-01-16, Days after vaccination: 0
Gender:Female  Submitted:2007-01-30, Days after onset: 14
Location:North Carolina  Entered:2007-01-31, 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:
Current Illness:
Preexisting Conditions: ASTHMA
Diagnostic Lab Data: pulse oximetry-within normal limits
CDC 'Split Type': WAES0701USA03520
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0 UN
Administered by: Other     Purchased by: Other
Symptoms: Chest pain, Hypersensitivity, Oxygen saturation normal
SMQs:, Angioedema (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: Information has been received from a LPN concerning a 17 year old female with asthma who on 16-JAN-2007 was vaccinated with a first dose of Gardasil vaccine (yeast). On 16-JAN-2007 the patient experienced burning in her chest and lungs. The patient was seen at an Urgent Care facility and her lungs were found to be clear and her oxygen saturation was within normal limits. The Urgent Care physician''s impression was that the patient experienced some type of allergic reaction. The patient was treated with Tylenol and Benadryl and instructed to come back if the symptoms did not improve or if they exacerbated. The LPN felt that there was a possibility of hospitalization at the time, however, at the time of this report, the patient was recovering and improving on treatment. No product quality complaint was involved. The reporter felt that allergic reaction was an other important medical event. Additional information has been requested.

VAERS ID:271720 (history)  Vaccinated:2007-01-29
Age:17.0  Onset:0000-00-00
Gender:Female  Submitted:2007-01-29
Location:Kansas  Entered:2007-02-05, 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:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)SANOFI PASTEURU1813AB0IMRA
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURZ00180SCLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0215F0SCRA
Administered by: Public     Purchased by: Public
Symptoms: Inappropriate schedule of drug administration, Medication error, Wrong drug administered
SMQs:
Write-up: Patient given Dtap instead of Tdap no previous record of immunization in past. Client is here for 1 month. Called state to verify possible harms to patient of need to patient vaccine. Patient has no signs/symptoms of reaction

VAERS ID:271773 (history)  Vaccinated:2007-01-08
Age:17.0  Onset:2007-01-13, Days after vaccination: 5
Gender:Female  Submitted:2007-01-26, Days after onset: 13
Location:North Carolina  Entered:2007-02-06, 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: NONE
CDC 'Split Type': NC07011
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.1210IMLA
YF: YELLOW FEVER (YF-VAX)AVENTIS PASTEUR4E944AA0SCRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Discomfort, Headache, Induration, Pain in extremity
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: 1-17-07 pc from mom pt started with discomfort, headache 4 days and (1-12-07) 3 days palpable not occipital bone meaty transverse growth. Has enlarged painful to touch, pain radiates down backside right arm. No other symptoms. 1/18/07 10:45 am pc talked to mom-improving knot resolving, less painful, no headache, no pain radiating down right arm, feeling much better, per pt in background. 1/14/07 pc spoke with mom, everything basically back to normal. 1/22/07 and 1/26/07 made numerous pc left messages no return calls.

VAERS ID:271819 (history)  Vaccinated:2007-01-29
Age:17.0  Onset:2007-01-31, Days after vaccination: 2
Gender:Female  Submitted:2007-02-01, Days after onset: 1
Location:Massachusetts  Entered:2007-02-06, 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:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1447F0UNUN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2158AA0UNUN
Administered by: Private     Purchased by: Private
Symptoms: Musculoskeletal pain, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad)
Write-up: 2 days after giving Menactra and HPV vaccine #1, pt developed L shoulder and L arm pain, with ok strength but pain with motion.

VAERS ID:272144 (history)  Vaccinated:2006-08-19
Age:17.0  Onset:2006-10-23, Days after vaccination: 65
Gender:Female  Submitted:2007-02-12, Days after onset: 112
Location:Illinois  Entered:2007-02-12
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: none~ ()~~0~In Patient
Other Medications: none
Current Illness: none records received 6/21/07-Five days prior to presentation to transferring facility patient had upper respiratory infection
Preexisting Conditions: none
Diagnostic Lab Data: MRI showed inflamation of pons to lower thoracic spinal cord. Patient also had large CSF leukocytosis with no positive viral, fungal or bacterial cultures. records received 6/21/07-Labs: CSF for PCR, West Nile, HSV, CMV, HIV, PB PCR all n
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURUE359AA0SCRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Antinuclear antibody negative, CSF cell count, CSF test abnormal, Continuous positive airway pressure, Cough, DNA antibody negative, Dyspnoea, Extubation, HIV antibody negative, Hypoaesthesia, Hypopnoea, Inflammation, Intubation, Leukocytosis, Leukoencephalomyelitis, Myelitis transverse, Nuclear magnetic resonance imaging abnormal, Paralysis, Polymerase chain reaction, Pyrexia, Rhinitis, Upper respiratory tract infection
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (narrow), Cardiomyopathy (broad), Demyelination (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad)
Write-up: Patient developed Acute Disseminated Encephalomyelitis. Patient was intubated on 10/24/2006 recieved course of high dose steriods, plasma exchange, was intubated for 6 weeks. Is paralized from mouth down. Patient is beginning to regain function. 6/21/07-records received for DOS 10/27-11/29/06 DC DX:Transverse Myelitis. Five days prior to presentation to transferring facility patient had upper respiratory infection symptoms of cough and coryza and developed a fever of 101. Three days prior to presentation patient developed left arm and back numbness which progressed to involve her left leg and right arm and right leg. She had some shortness of breath. Weakness ensued in all extremities and patient quickly became quadraplegic. MRI revealed transverse myelitis at level of medulla and upper cerivcal cord. Condition deteriorated where deep tendon reflexes could not be elicited. and sensory exam showed severely decreased pinkprick and light touch sensation in all extremities. Initially treated with IVIG with no significant improvement. High dose steroids and plasmapheresis at which time sligh improvment was noted. Venitaltor support, trach and PEG. Weaned from vent. However, did show hypopnea at nighttime during sleep. CPAP used. Improvement in sensation. Transferred to rehab.

VAERS ID:272262 (history)  Vaccinated:2007-02-05
Age:17.0  Onset:0000-00-00
Gender:Female  Submitted:2007-02-15
Location:Pennsylvania  Entered:2007-02-15
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: LMP 2-4-07
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB300AA0IMLA
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURY10680SCRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC2492BA0IMRA
Administered by: Public     Purchased by: Public
Symptoms: Inappropriate schedule of drug administration
SMQs:
Write-up: MMRV (ProQuad) given $g age 12 years.

VAERS ID:272286 (history)  Vaccinated:2007-01-02
Age:17.0  Onset:2007-01-02, Days after vaccination: 0
Gender:Female  Submitted:2007-02-14, Days after onset: 43
Location:Arizona  Entered:2007-02-15, 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: NONE
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0701USA00601
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0SC 
Administered by: Other     Purchased by: Other
Symptoms: Incorrect route of drug administration, Injection site bruising, Injection site reaction, 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: Information has been received from al licensed practical nurse concerning a 17 year old female with no pertinent medical history, who on 02-JAN-2007 was vaccinated with the first dose of Gardasil. There was no concomitant medication. The nurse reported that the patient received the vaccination via the subcutaneous route and on 02-JAN-2007, developed in injection site reaction. The reaction was described as being that of a swollen and bruised injections site on the patients shoulder. Unspecified medical attention was sought. The patient subsequently recovered on 03-JAN-2007.

VAERS ID:272308 (history)  Vaccinated:2006-12-29
Age:17.0  Onset:2006-12-29, Days after vaccination: 0
Gender:Female  Submitted:2007-04-06, Days after onset: 97
Location:Unknown  Entered:2007-02-15, Days after submission: 49
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: UNK
Diagnostic Lab Data:
CDC 'Split Type': WAES0701USA01079
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1424F0UNUN
Administered by: Other     Purchased by: Other
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Information has been received from a physician concerning an 18 year old female with pertinent medical history and drug reaction/allergies not reported who on 29-DEC-2006 was vaccinated with the first dose of Gardasil (Lot #654885/1424F), injection, 0.5ml. Concomitant medication was not reported. ON 29-DEC-2006, the patient developed hives within hours of receiving the first dose of Gardasil. The physician reported that the hives became more generalized within 24 hours. On 29-DEC-2006, therapy with human papillomavirus vaccine was discontinued. Subsequently on an unspecified date, the patient recovered from hives. Additional information has been requested. This is in follow-up to report (s) previously submitted on 2/14/2007. Information has been received from a physician concering his daughter an 18 year old female with pertinent medical history and drug reactions/allergies not reported who on 29-DEC-2006 was vaccinated with the first dose of GARDASIL (lot #654885/1424F), injection, 0.5 mL. Concomitant medication was not reported. On 29-DEC-2006, the patient developed hives at the injection site within hours of receiving the first dose of GARDASIL. The physician reported that "the hives became more generalized within 24 hours" and the patient "then developed hives on her trunk and knee the next day." On 29-DEC-2006, therapy with human papillomavirus vaccine was discontinued. Subsequently 48 hours after the vaccination, the patient recovered from hives. Additional information has been requested.

VAERS ID:272330 (history)  Vaccinated:2006-11-02
Age:17.0  Onset:2006-12-01, Days after vaccination: 29
Gender:Female  Submitted:2007-02-14, Days after onset: 75
Location:Pennsylvania  Entered:2007-02-15, 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
Diagnostic Lab Data: Serum HIV-1 p24, 12/06, false positive
CDC 'Split Type': WAES0701USA01810
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  IM 
Administered by: Other     Purchased by: Other
Symptoms: HIV test false positive
SMQs:
Write-up: Information has been received from a physician concerning a 17 year old female with no medical history or allergies, who on 14-AUG-2006 on 02-NOV-2006 was vaccinated IM with a first and second 0.5 ml dose of HPV rL1 6 11 16 18 VLP vaccine (yeast). There was no concomitant medication. In December 2006, the patient had a false positive HIV result. It was noted that the physician stated that the patient had no risk factors for HIV. Unspecified medical attention was sought. At the time of this report, the patient''s outcome was unknown. No product quality complaint was involved. Additional information has been requested.

VAERS ID:272483 (history)  Vaccinated:2007-01-18
Age:17.0  Onset:2007-01-18, Days after vaccination: 0
Gender:Female  Submitted:2007-02-14, Days after onset: 27
Location:Hawaii  Entered:2007-02-15, 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:
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0701USA03099
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  IMLA
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia
SMQs:, Arthritis (broad)
Write-up: Information has been received from a physician concerning a 17 year old female with no pertinent medical history and no drug reactions/allergies who on approximately 18-JAN-2007 was vaccinated with GARDASIL (lot # not reported) injection, 0.5 ml, in her left upper arm. There was no concomitant medication. On 18-JAN-2007, the patient developed pain and soreness in both sides of her hips. The patient sought medical attention. No lab diagnostic tests were performed. The patient stated that as of 18-JAN-2007, she only feels pain when she touches the side of her hips. At the time of reporting the outcome was unspecified. No other information was provided by the physician. Additional information has been requested. This is in follow-up to report(s) previously submitted on 2/14/2007. Additional information was received from the physician via telephone call. The physician reported that the patient had not returned for follow-up visit, therefore it was unknown if the patient recovered. Additional information has been requested.

VAERS ID:272505 (history)  Vaccinated:2007-01-01
Age:17.0  Onset:2007-01-01, Days after vaccination: 0
Gender:Female  Submitted:2007-02-14, Days after onset: 44
Location:Florida  Entered:2007-02-15, 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:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data:
CDC 'Split Type': WAES0701USA03908
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1208F1IMUN
Administered by: Other     Purchased by: Other
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Information has been received from a physician concerning a female (demographics not reported) who on an unspecified date was vaccinated with Gardasil (yeast) (Lot# not provided). Subsequently the patient developed hives. At the time of this report it was unknown if the patient had recovered from the hives. Additional information has been requested. This is in follow-up to report(s) previously submitted on 2/14/2007. Follow up information received stated that the patient developed hives after receiving the second dose of GARDASIL (Lot # not provided) on an unspecified date in approximately January, 2007. The patient was treated in the physicians office with a dose of an unspecified antihistamine. At the time of this report it was not reported if the patient had recovered from the event. Additional information has been requested.

VAERS ID:272517 (history)  Vaccinated:2006-11-01
Age:17.0  Onset:2006-12-01, Days after vaccination: 30
Gender:Female  Submitted:2007-02-14, Days after onset: 75
Location:Oregon  Entered:2007-02-15, 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: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: serum HIV-1 gag, 12/06, positive; serum HIV-1 gag, equivocal; serum HIV-1 gag, negative
CDC 'Split Type': WAES0701USA04101
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0  
Administered by: Other     Purchased by: Other
Symptoms: HIV test, HIV test negative, HIV test positive
SMQs:
Write-up: Information has been received from a health professional concerning a 17 year old female who in November 2006, was vaccinated with a first dose of HPV vaccine (yeast). In December 2006, the patient tested positive for human immunodeficiency virus (HIV). The HIV test was performed in December 2006 when the patient donated blood. Unspecified medical attention was sought. The patient had 2 subsequent HIV tests. The first test was "equivocal" and the second test was negative. It was reported that the patient was not sexually active and did not use intravenous (IV) drugs. At the time of the report, the patient''s outcome was unknown. Additional information has been requested.

VAERS ID:272520 (history)  Vaccinated:2007-01-16
Age:17.0  Onset:2007-01-17, Days after vaccination: 1
Gender:Female  Submitted:2007-04-06, Days after onset: 78
Location:North Carolina  Entered:2007-02-15, Days after submission: 49
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Asthma; Drug hypersensitivity
Preexisting Conditions: Distress gastrointestinal
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0701USA04212
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1427F  UN
Administered by: Other     Purchased by: Other
Symptoms: Burning sensation, Chest discomfort, Hypersensitivity, Lung disorder, Palpitations, Vision blurred
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Hypersensitivity (narrow)
Write-up: Information has been received from a nurse practitioner concerning a female who was vaccinated with a 0.5 ml dose of Gardasil (yeast). Subsequently the patient developed an "allergic reaction". Unspecified medical attention was sought. At the time of the report, the patient''s outcome was unknown. Additional information has been requested. This is in follow-up to report (s) previously submitted on 2/14/2007. Initial and follow-up information has been received from a nurse practitioner and a licensed practical nurse concerning a 17 year old female student with asthma and drug hypersensitivity to BEXTRA (gastrointestinal distress) who on 16-JAN-2007, at 16:05, was vaccinated, intramuscularly, into the left deltoid, with a first dose of GARDASIL (lot #655619/1427F). On 17-JAN-2007 the patient called the physician''s office with complaint of "lungs burning" and felt like she had heartburn. She reported that she felt her heart was racing and had developed blurry vision. The patient went to urgent care and told by the physician that the events were a possible reaction to GARDASIL. The patient was advised to take BENADRYL and TYLENOL PM. It was reported that the patient was resting comfortably after she was seen in urgent care. On 18-JAN-2007, she had some residual chest tightness. The patient did not experience shortness of breath or difficulty breathing. Subsequently, the patient recovered. No further information is available.

VAERS ID:272531 (history)  Vaccinated:2006-12-31
Age:17.0  Onset:2006-12-31, Days after vaccination: 0
Gender:Female  Submitted:2007-02-14, Days after onset: 45
Location:Unknown  Entered:2007-02-15, 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: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0701USA04481
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 1  
Administered by: Other     Purchased by: Other
Symptoms: Meningism, Musculoskeletal stiffness
SMQs:, Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (narrow), Arthritis (broad)
Write-up: Information has been received from a nurse concerning a 17 year old female who at the "end of December" was vaccinated with a second dose of HPV VLP vaccine (yeast) (0.5 ml). Subsequently, the patient experienced meningitis like symptoms and cervical neck stiffening. Unspecified medical attention was sought. At the time of the report, th patient was recovering. Additional information is not expected.

VAERS ID:272583 (history)  Vaccinated:2006-12-11
Age:17.0  Onset:2006-12-11, Days after vaccination: 0
Gender:Female  Submitted:2007-02-14, Days after onset: 65
Location:Washington  Entered:2007-02-15, 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:
Current Illness: Smoker
Preexisting Conditions: Rash; Diarrhoea; Chickenpox
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0701USA04672
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0688F1IMUN
Administered by: Other     Purchased by: Other
Symptoms: Blister, Burning sensation, Herpes zoster, Urticaria
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Hypersensitivity (narrow)
Write-up: Information has been received from a nurse practitioner concerning an 18 year old female patient who was vaccinated with her first dose of HPV vaccine (yeast) and had no adverse side effects. Subsequently, she was vaccinated with her 2nd dose of HPV vaccine (yeast) and within 24 hours broke out in hives, which developed into shingles. Medical attention was sought. As of the report date, the patient was recovering. Additional information has been requested. Follow up information has been received from a Certified Medical Assistant and medical records concerning a 17 year old female stundent with current tobacco use and a history of rash with CEFZIL and CECLOR, diarrhoea with AUGMENTIN and chickenpox who on 11-DEC-2004 at 2:35 p.m. was vaccinated IM in left arm with her second dose of GARDASIL, lot #653735/068HF. Concomitant therapy included YASMIN 28 and Sulfamethoxazole and trimethoprim. The reporter indicated that the patient developed hives post injection, then on 18-DEC-2006 was seen at an urgent care clinic for shingles, which was not felt to be related to the immunization. The patient recovered on an unspecified date. According to medical notes from 18-DEC-2006. Patient states she''s here for compains of a rash on her back and under her right armpit, and she describes the pain as an 8/10. States it started last Wednesday (13-DEC-2006) but it''s gotten much worse. States she had the 2nd HPV immunization last Monday, and they wonder if this might be a reaction to it. "It was also reported that the patient did have a burning/pain sensation prior to 13-DEC-2006 and prior to the administration of GARDASIL and blistering. The blisters were in clumps/painful, and were aggravated by touching. The patient stated she was under a lot of stress with school and that she had some low grade fevers. Her assessment was shingles, right T5 dermatone - increase vesicles in patches along the T5 dermatone. She was treated with VALTREX. 1 tablet 3 times daily and Tylenol with Codeine #3). 1 tablet every 4 hours as needed for pain. Additional information is not expected.

VAERS ID:272596 (history)  Vaccinated:2006-12-01
Age:17.0  Onset:2006-12-16, Days after vaccination: 15
Gender:Female  Submitted:2007-02-14, Days after onset: 60
Location:Indiana  Entered:2007-02-15, 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:
Current Illness: Amenorrhea, Hirsutism, Allergic reaction to antibiotics
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0701USA04857
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0IM 
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEUR   UN
Administered by: Other     Purchased by: Other
Symptoms: Erythema nodosum
SMQs:, Hypersensitivity (narrow)
Write-up: information has been received from a physician concerning a 17 year old female with amenorrhea, hirsutism and a CECLOR allergy who on 01-DEC-2006 was vaccinated IM with a first dose of Gardasil (yeast). The patient received Menactra concomitantly. Other concomitant therapy included Ovcon 50. On 16-DEC-2006 the patient developed erythema nodosum. The patient sought unspecified medical attention. The patient was treated with a course of steroids and has fully recovered. No laboratory diagnostic tests were performed. No product quality complaint was involved. Additional information has been requested.

VAERS ID:272624 (history)  Vaccinated:0000-00-00
Age:17.0  Onset:0000-00-00
Gender:Female  Submitted:2007-02-14
Location:Pennsylvania  Entered:2007-02-15, 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:
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0702USA00208
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  IM 
Administered by: Other     Purchased by: Other
Symptoms: Hypoaesthesia, Nervous system disorder, Pain in extremity
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: Information has been received from a nurse practitioner concerning a 17 year old female who was vaccinated, intramuscularly with HPV vaccine. The nurse reported that the patient was having "neurological problems" after receiving the vaccine. The reporter stated that the patient explained she was having "pain and numbness" in her extremities. The reporter stated the patient was going to see a neurologist. At the time eof the report, it was unknown, if the patient recovered. Additional information has been requested.

VAERS ID:272473 (history)  Vaccinated:2006-07-17
Age:17.0  Onset:2006-10-01, Days after vaccination: 76
Gender:Male  Submitted:2007-02-16, Days after onset: 138
Location:Maryland  Entered:2007-02-16
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: Lyme Disease PMH: Lyme dx 7/06. Barbosa. ADHD. unexplained seizures at birth.
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)AVENTIS PASTEURU2108AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Areflexia, Electromyogram abnormal, Guillain-Barre syndrome, Hyporeflexia, Muscular weakness, Nuclear magnetic resonance imaging normal
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Noninfectious encephalopathy/delirium (broad), Demyelination (narrow)
Write-up: Guillain Barre Syndrome. 3/1/07 Received medical records from PCP which reveals patient experienced Lymes disease in 7/05 after receiving multiple mosquito bites at summer camp in NY. Fever of 102, blotchy rash & fatigue. Treated w/antibiotics. In 10/06, felt Lymes worsening & eval by ortho included MRI of shoulder & cspine. which were reported as WNL. Saw neuro also & EMG of UE & LE reported as WNL. PCP note of 11/06 states neuro now thinks GBS & weakness had improved. By 2/07 was symptom free w/resolved muscle weakness. 3/30/07 Received medical records from neurologist which reveal patient was initially evaluated on 10/23/06 after experienced weakness of bilat UEs. Weakness had started approx 2-3 wks prior when he noted having difficulty raising his arm & had pain in sides of his neck radiating to shoulders bilat when turned head to that particular side. Neuro exam revealed gen weakness of shoulder abductors & hip flexors. DTRs were absent in UEs & right knee and decreased in left knee & both ankles. EMG/NCS done that day revealed decreased recruitment suggesting central process. MRI of brain & c-spine was to be reviewed. Returned to office on 11/2/06. MRI was read as WNL. Strength had improved but right remained weaker than left arm. It was felt that his constellation of s/s was suggestive of GBS, resolving spontaneously. Returned to office on 11/13/06 & continued to improve & regain strength. He was d/c from neuro f/u at that point & permitted to return to sports. No EMG/NCS report was included with records. FINAL DX: acute inflammatory polyradicular neuropathy (GBS). 4/5/07 Per direction of CDC: Please change the lot # that was entered for VAERS # 272473. It was reported incorrectly. The correct lot # for the Menactra given was U2108AA. Please correct this is the VAERS database.

VAERS ID:272771 (history)  Vaccinated:2007-02-07
Age:17.0  Onset:2007-02-09, Days after vaccination: 2
Gender:Female  Submitted:2007-02-20, Days after onset: 11
Location:Florida  Entered:2007-02-20
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: THROAT CULTURE TO RULE OUT STREP PN 2/13/07. RESULTS WERE NEGATIVE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0962F0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Culture throat negative, Rash erythematous, Rash papular, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: AFEBRILE ERYTHEMATOUS FINE PAPULAR PRURITIC RASH ON CHEST, LEGS, BACK AND ABDOMEN BEGINNING 2 DAYS POST VACCINATION. PRURITITS AND ERYTHEMA RESPONDED TO ORAL BENADRYL.

VAERS ID:272889 (history)  Vaccinated:2007-02-12
Age:17.0  Onset:2007-02-12, Days after vaccination: 0
Gender:Female  Submitted:2007-02-21, Days after onset: 9
Location:Unknown  Entered:2007-02-22, 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: Penicillin allergy
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0702USA02754
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0014U IM 
Administered by: Other     Purchased by: Other
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Information has been received from a nurse practitioner concerning a 17 year old female with penicillin allergy who on 12-FEB-2007 was vaccinated with Gardasil 0.5ml intramuscularly (lot number 653736/0014U). There was no concomitant medication. On 12-FEB-2007, 45 to 60 minutes post vaccination, the patient called the physician''s office stating that she had hives on her arms and legs. The treatment was Benadryl. On 13-FEB-2007, the patient was seen at the physician''s office and still had hives on her arms and legs but no shortness of breath. No other treatment was given. The hives were improving. Hives on arms and legs were considered an other important medical event. Additional information has been requested.

VAERS ID:272940 (history)  Vaccinated:2006-12-22
Age:17.0  Onset:2006-12-22, Days after vaccination: 0
Gender:Female  Submitted:2007-02-22, Days after onset: 62
Location:Florida  Entered:2007-02-23, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Asthma
Preexisting Conditions:
Diagnostic Lab Data: X-ray 02/12?/07 - No bony abnormalities
CDC 'Split Type': WAES0702USA03448
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0800F0IM 
Administered by: Other     Purchased by: Other
Symptoms: Insomnia, Medical device complication, Musculoskeletal pain, Pain, X-ray normal
SMQs:, Rhabdomyolysis/myopathy (broad)
Write-up: Information has been received from a physician and an office manager concerning a 17 year old female with asthma who on 22-DEC-2006 was vaccinated IM, into the left arm, with a 0.5 ml first dose of Gardasil (lot#654540/0800P). It was reported that at the end of the administration the "safety spring plunger snapped back and caused the patient pain." The office manager explained that this incident was due to human error, the physician was unfamiliar with safety mechanism. On 22-DEC-2006, the patient experienced left shoulder pain and difficulty sleeping on her left arm. On approximately 12-FEB-2007, the patient saw an orthopedic surgeon. The patient underwent an X-ray which revealed no bony abnormality. The orthopedic surgeon recommended that the patient go to physical therapy. At the time of the report, the patient had not recovered. The physician considered the left shoulder pain and difficulty sleeping on her left arm to be disabling events. Additional information has been requested.

VAERS ID:272978 (history)  Vaccinated:2007-02-16
Age:17.0  Onset:2007-02-16, Days after vaccination: 0
Gender:Female  Submitted:2007-02-20, Days after onset: 4
Location:Virginia  Entered:2007-02-23, 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: Mircette-28
Current Illness: mild viral URI
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1424F0IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Headache, Muscular weakness, Nausea, Paraesthesia, Photophobia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (broad)
Write-up: Approx. 2 hours after receiving HPV vaccine pt. developed tingling in left arm (vaccine given in left arm) and then in left leg. At times both extremities felt slight "weak". Pt developed severe right sided headache with nausea and photophobia

VAERS ID:273204 (history)  Vaccinated:2007-02-03
Age:17.0  Onset:2007-02-04, Days after vaccination: 1
Gender:Female  Submitted:2007-03-01, Days after onset: 25
Location:New York  Entered:2007-03-01
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: Labs and CT abdomen and pelvis --negative
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME)UNKNOWN MANUFACTURER30011393PO 
Administered by: Unknown     Purchased by: Private
Symptoms: Abdominal pain, Computerised tomogram normal, Laboratory test normal
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Abdominal pain, severe, Emergency Department visit X3 with negative work up including CT.Symptoms began 24 to 48 hours after oral typoid and were mild after first dose and severe after the third. Described as crampy with crescendo/decrescendo pattern.

VAERS ID:273326 (history)  Vaccinated:2007-02-23
Age:17.0  Onset:2007-02-23, Days after vaccination: 0
Gender:Male  Submitted:2007-03-02, Days after onset: 7
Location:Utah  Entered:2007-03-02
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: Allergy to Ibuprofen
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)AVENTIS PASTEURU1875AA0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Chills, Discomfort, Dizziness, Headache, Nausea, Pallor, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Received Menactra and PPD on Friday, Feb 23, 2007. About 10 minutes after the shots he got a headache and on Saturday he still had a headache. Saturday evening he got a fever. Sunday he woke up with a headache, nausea, vomiting, light headed, and fever of 103. Fever came down with Excedrin and returned Sunday evening. Client came into health department Monday morning (2-26-07) and still has a headache and fever. Feeling chills this morning, but no longer nauseated. Client did look pale and uncomfortable. Referred to personal physician if symptoms worsen or do not improve. Called to follow up on 3-2-07 and spoke with client''s grandfather and said client has recovered and did not need to go to his physician.

VAERS ID:273357 (history)  Vaccinated:2007-01-05
Age:17.0  Onset:2007-01-05, Days after vaccination: 0
Gender:Female  Submitted:2007-03-01, Days after onset: 55
Location:New York  Entered:2007-03-02, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0702USA04223
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0955F0IMUN
Administered by: Private     Purchased by: Other
Symptoms: Malaise, Pallor, Somnolence, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Information has been received from physician concerning a 16 year old female patient who on approximately 05-JAN-2007 ("7 weeks ago") was vaccinated with the first dose, 0.5ml, IM, of Gardasil. There was no concomitant medication. The physician reported that the patient stated she "did not feel well when checking out and turned white and fainted when being taken back into the examining room." The physician clarified that the patient "did not lose consciousness or hit her head because he caught the patient." He confirmed the patient fainted "within 5 minutes" of the vaccination, and remained "groggy for up to 30 minutes" after the vaccination. The patient was then "considered recovered," and left the office. The physician considered the events to be disabling. Additional information has been requested.

VAERS ID:273408 (history)  Vaccinated:2006-12-18
Age:17.0  Onset:2006-12-19, Days after vaccination: 1
Gender:Female  Submitted:2007-02-26, Days after onset: 69
Location:Michigan  Entered:2007-03-05, 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: UNK
Preexisting Conditions: The subject''s medical history, concurrent condition, and concurrent medications were not reported.
Diagnostic Lab Data: UNK
CDC 'Split Type': A063357A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB285AA1 UN
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B007AA1 LA
Administered by: Public     Purchased by: Public
Symptoms: Injection site pain, Injection site swelling, Wrong drug administered
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: This case was reported by a healthcare professional and described the occurrence of injection site pain in a 17-year-old female subject who was inadvertently vaccinated with Boostrix for prophylaxis. Concurrent vaccination included Engerix-B, administered on 18 December 2006. This was the subject''s 2nd dose of hepatitis B vaccine. On 19 October 2006, the subject received 1st dose of Boostrix. On 18 December 2006 at 15:30 the subject inadvertently received 2nd dose of Boostrix (left arm) rather than the intended administration of Menactra. One day following the 2nd dose of Boostrix, on 19 December 2006, the subject experienced ''mild" injection site pain and injection site swelling at the site of the Boostrix administration. The events resolved on 21 December 2006. The healthcare professional considered the events were probably related to vaccination with Boostrix and could have been associated with the inadvertent administration of a 2nd of Boostrix.

VAERS ID:273417 (history)  Vaccinated:2007-02-15
Age:17.0  Onset:0000-00-00
Gender:Female  Submitted:2007-03-05
Location:North Carolina  Entered:2007-03-05
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
DTAP: DTAP (TRIPEDIA)AVENTIS PASTEURAC21B065AA5IMRA
Administered by: Private     Purchased by: Public
Symptoms: Inappropriate schedule of drug administration, No adverse effect
SMQs:
Write-up: NO adverse SE was reported.

VAERS ID:273453 (history)  Vaccinated:2007-03-05
Age:17.0  Onset:2007-03-05, Days after vaccination: 0
Gender:Female  Submitted:2007-03-05, Days after onset: 0
Location:California  Entered:2007-03-05
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.018840IMLA
Administered by: Private     Purchased by: Private
Symptoms: Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Patient fainted.

VAERS ID:273456 (history)  Vaccinated:2007-02-22
Age:17.0  Onset:2007-03-02, Days after vaccination: 8
Gender:Male  Submitted:2007-03-02, Days after onset: 0
Location:California  Entered:2007-03-05, Days after submission: 3
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: Chronic respiratory failure, Severe Kyphoscolosis
Diagnostic Lab Data: 3/5/7 Culture back abscess - scant growth of staph aureus, given CIPRO, etc.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2208AA0IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0958F0IMRA
Administered by: Private     Purchased by: Private
Symptoms: Abscess drainage, Culture positive, Inappropriate schedule of drug administration, Staphylococcus test positive, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Patient given 3 cc of PNEUMOVAX IM. Follow-up information received - (2) Chronic swelling on scar tissue of back - ruptured and drained pus. Started on CIPRO oral 500 mg tab BID X 6 weeks.

VAERS ID:273469 (history)  Vaccinated:2007-01-01
Age:17.0  Onset:2007-01-01, Days after vaccination: 0
Gender:Female  Submitted:2007-03-05, Days after onset: 63
Location:California  Entered:2007-03-06, 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:
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0702USA04695
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0012U0 UN
Administered by: Private     Purchased by: Other
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: Information has been received from a physician, via a company representative, concerning a 16 year old female patient who in January 2007 ("last month"), was vaccinated with the first dose, 0.5ml, of Gardasil. The physician reported that in January 2007 ("last month"), the patient experienced a grand mal seizure after receiving her first dose. In addition, the physician reported that the "patient has no history of seizures and was taken to the ER. The physician did not know if the patient was admitted. It was unknown if the patient recovered. Upon internal review, grand mal seizure was determined to be an other medical event. Additional information has been requested.

VAERS ID:273513 (history)  Vaccinated:2006-12-14
Age:17.0  Onset:2006-12-14, Days after vaccination: 0
Gender:Female  Submitted:2007-03-06, Days after onset: 82
Location:New York  Entered:2007-03-07, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: ORTHO TRI-CYCLEN
Current Illness: Penicillin allergy
Preexisting Conditions: Drug rash
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0703USA00049
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0 UN
Administered by: Other     Purchased by: Other
Symptoms: Back pain, Neck pain, Pain in extremity, Pain in jaw
SMQs:, Retroperitoneal fibrosis (broad), Osteonecrosis (broad), Arthritis (broad)
Write-up: Information has been received from a physician concerning a 17 year old female patient with a history of rash after taking amoxicillin, who on 14-DEC-2006 was vaccinated with the first dose, 0.5 ml, in the right arm, of Gardasil. Concomitant therapy included (ORTHO TRI-CYCLEN). In December 2006 (date not specified), the patient "experienced pain at left angle of jaw, neck pain and mid back pain. "The physician reported that the "mother treated daughter with ibuprofen and within 36 hours symptoms improved. The physician stated "the client did not report this reaction at the time. "On 20-FEB-2007 a second dose , 0.5ml, in the left arm, of Gardasil was administered. On 25-FEB-2007, the patient called the office, "complaining of pain at left angle of jaw, mid back pain, and pain in the right deltoid, upper aspect of the right arm, the opposite arm" of where she received the vaccination. At the time of this report it was unknown if the patient had recovered. The physician considered the events to be significantly disabling. Additional information has been requested.

VAERS ID:273538 (history)  Vaccinated:2007-02-23
Age:17.0  Onset:2007-02-24, Days after vaccination: 1
Gender:Female  Submitted:2007-03-01, Days after onset: 5
Location:Massachusetts  Entered:2007-03-07, Days after submission: 6
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: Unknown
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.018740IMUN
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Myalgia, Pharyngolaryngeal pain, Streptococcus serology, Swelling
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: Pt developed arthralgia, swelling and myalgia involving hands, fingers, elbow joint, toes and ankle joints in 2x hrs after vaccination. Also pt developed sore throat 4 days after immunization. This is in follow-up to report (s) previously submitted on 4/6/2007. Initial and follow-up information has been received from a registered nurse concerning a 17 year old female, with no pertinent medical history who on 23-Feb-2007 was vaccinated with the first dose of GARDASIL (lot # 656049/0187U). On 07-Feb-2007 patient developed arthralgia, myalgia and sore throat. The patient was seen by a pediatrician on 01-Mar-2007. The patient will not receive GARDASIL in the future. NSAID therapy was recommended. No blood work was performed. The patient was advised to return in 1 week if not better. The patient had not returned to date. Patient''s outcome was unkn own. Additional information has been requested.

VAERS ID:273583 (history)  Vaccinated:2007-02-21
Age:17.0  Onset:2007-02-22, Days after vaccination: 1
Gender:Female  Submitted:2007-02-28, Days after onset: 6
Location:Connecticut  Entered:2007-03-07, 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:
Preexisting Conditions: Asthma
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0013U0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Pt developed rash over torso following day after vaccine administered. Rash worsened over week (red patches, itching). Referred to dermatologist given RX clobetasol Propionate and Zyrtec.

VAERS ID:273789 (history)  Vaccinated:2007-03-09
Age:17.0  Onset:2007-03-10, Days after vaccination: 1
Gender:Female  Submitted:2007-03-12, Days after onset: 1
Location:Michigan  Entered:2007-03-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Prevacid 30mg Q day / Allegra
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.001300IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)AVENTIS PASTEURU1968AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Body temperature increased, Chills
SMQs:, Neuroleptic malignant syndrome (broad)
Write-up: Elevated temp and chills approx. 16 hours after vaccine given

VAERS ID:273790 (history)  Vaccinated:2007-03-09
Age:17.0  Onset:2007-03-09, Days after vaccination: 0
Gender:Female  Submitted:2007-03-12, Days after onset: 2
Location:Georga  Entered:2007-03-12
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 to Pertussis vaccine
Diagnostic Lab Data: none
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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Site
HPVX: HPV (NO BRAND NAME)UNKNOWN MANUFACTURER 0SCLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Anxiety, Deafness, Fatigue, Flushing, Hypoaesthesia, Injected limb mobility decreased, Nausea, Pain in extremity, Syncope, Vertigo
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (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), Hearing impairment (narrow), Vestibular disorders (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad)
Write-up: 10:30am - Within 10 minutes of receiving vaccine, she fainted. She began to experience severe pain in her left arm with numbness in her hands and fingers. She had feelings of impending dome. 11:30am - She returned to school approximately 1 hour after the injection, but her symptoms did not improve and worsened. She was unable to use her left arm do to the pain and lack of feeling/strength in her hand. She then had periods of hearing loss. She experienced nausea, vertigo, facial flushing, upper chest flushing, and profound fatigue. 12:30pm - I returned her back to the MD office. There they did vital signs and administered Bendaryl by mouth. Her symptoms lasted 12 hours. By the next morning, she back to normal.

VAERS ID:273909 (history)  Vaccinated:2007-03-05
Age:17.0  Onset:2007-03-05, Days after vaccination: 0
Gender:Female  Submitted:2007-03-13, Days after onset: 7
Location:Ohio  Entered:2007-03-14, 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:
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: nasal sinus X-ray 03/05/07 - negative
CDC 'Split Type': WAES0703USA01199
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0263U0IM 
Administered by: Other     Purchased by: Other
Symptoms: Eye infection, Eye swelling, Face and mouth X-ray normal, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Ocular infections (narrow), Hypersensitivity (narrow)
Write-up: Information has been received from a physician concerning a 17 year old female who on 05-MAR-2007 was vaccinated IM with the first dose of Gardasil. Concomitant therapy included hormonal contraceptives (unspecified). On 05-MAR-2007, two hours post-vaccination, the patient developed swollen eyes and face and went to an emergency room. The patient underwent sinus films, which were noted to be negative, and was administered BENADRYL and unspecified antibiotics for a possible eye infection. The patient was released that same evening. On 07-MAR-2007, the physician contacted the patient and reported that there was "not much improvement." The patient''s swollen eyes and face persisted. Eye and face swelling were reported as other important medical events. Additional information has been requested.

VAERS ID:273919 (history)  Vaccinated:2007-02-23
Age:17.0  Onset:2007-02-26, Days after vaccination: 3
Gender:Female  Submitted:0000-00-00
Location:New York  Entered:2007-03-14
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: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0012U1IM 
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: Two days after injection, complained of joint pains, myalgia not relieved with use if Ibuprofen missed 2 days of school.

VAERS ID:274071 (history)  Vaccinated:2007-03-05
Age:17.0  Onset:2007-03-05, Days after vaccination: 0
Gender:Female  Submitted:2007-03-15, Days after onset: 9
Location:Ohio  Entered:2007-03-16, 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: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: diagnostic laboratory - respiratory panel
CDC 'Split Type': WAES0703USA01473
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0  
Administered by: Other     Purchased by: Other
Symptoms: Dysphonia, Eye swelling, Laboratory test, Nasal congestion, Swelling face, Tenderness, Throat irritation
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow)
Write-up: Information has been received from a physician concerning a 17 year old female who on 05-MAR-2007 was vaccinated by injection with the first dose of Gardasil. It was reported that the patient experienced an adverse experienced 2 hours after receiving Gardasil. The patient went to the emergency room with a swollen face and eyes, no fever reported. The patient received eye drops and BENADRYL. On 06-MAR-2007 the patient returned to the clinic with tender and a "little puppy eyes". On 07-MAR-2007 the patient had an itchy throat and her eyes were still tender. On 08-MAR-2007, the patient sounded "nasal". The pat6ient sought unspecified medical attention. The physician added an antibiotic and the patient was still taking diphenhydramine hydrochloride. The patient has a "respiratory panel". The physician reported that the patient will not continue the series. At the time of the report, it was unknown if the patient recovered. The physician considered swollen face and eyes, tender eyes, itchy throat, and sounded "nasal" to be other important medical events.

VAERS ID:274196 (history)  Vaccinated:2007-01-26
Age:17.0  Onset:2007-01-26, Days after vaccination: 0
Gender:Female  Submitted:2007-03-14, Days after onset: 46
Location:Wisconsin  Entered:2007-03-16, 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: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0702USA01324
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0IM 
Administered by: Other     Purchased by: Other
Symptoms: Injection site rash
SMQs:, Hypersensitivity (narrow)
Write-up: Information has been received from a physician concerning a 17 year old female who on 26 Jan 2007 was vaccinated intramuscularly with a first 0.5 mL dose of Gardasil. On 26 Jan 2007 the patient developed a rash at her injection site. The patient sought unspecified medical attention. On 27 Jan 2007 the patient recovered. No product quality complaint was involved. Additional information has been requested.

VAERS ID:274219 (history)  Vaccinated:2006-10-17
Age:17.0  Onset:2006-10-17, Days after vaccination: 0
Gender:Female  Submitted:2007-03-14, Days after onset: 148
Location:California  Entered:2007-03-16, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: Pregnancy NOS (LMP = 10/18/06), Penicillin allergy; Drug Hypersensitivity
Preexisting Conditions:
Diagnostic Lab Data: ultrasound 12/11/06 - prenatal testing: 8 weeks and 2 days, serum alpha-fetoprotein 12/11?/06 - positive screen for neural tube defect
CDC 'Split Type': WAES0702USA02440
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0800F IM 
Administered by: Other     Purchased by: Other
Symptoms: Alpha 1 foetoprotein abnormal, Drug exposure during pregnancy, Neural tube defect, Pregnancy test positive, Ultrasound scan
SMQs:, Congenital, familial and genetic disorders (narrow), Tumour markers (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Foetal disorders (broad), Normal pregnancy conditions and outcomes (narrow)
Write-up: Information has been received from a licensed practical nurse (LVN) as part of the pregnancy registry concerning a 17 year old female with penicillin allergy and drug reaction/allergy to DARVOCET, and VICODIN. She had no other concurrent medical conditions, or significant past medical history including no history or pregnancies. On 17-OCT-2006, the patient was vaccinated with first dose of Gardasil (yeast) (lot # 654540/0800F also reported as 653937/0637F) 0.5 ml IM. There was no concomitant medication. The patient''s last menstrual period was 18-OCT-2006. Medical attention was sought. On 11-DEC-2006, an ultrasound was performed that revealed pregnancy of 8 weeks and 2 days (estimated date of delivery 25-JUL-2007). On approximately 11-DEC-2006, maternal serum alpha-fetoprotein (MSAFP) test was performed that indicated the baby was at increased risk (positive) for neural tube defect (NTD). Medication taken during the pregnancy included prenatal vitamins. The patient was scheduled for follow-up testing with a perinatologist. No other information was available at the time of reporting. Additional information has been requested.

VAERS ID:274224 (history)  Vaccinated:2006-11-01
Age:17.0  Onset:2006-11-01, Days after vaccination: 0
Gender:Female  Submitted:2007-03-14, Days after onset: 132
Location:Unknown  Entered:2007-03-16, 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: Attention deficit/hyperactivity disorder
Preexisting Conditions: Shellfish allergy; Attention deficit/hyperactivity disorder
Diagnostic Lab Data: None
CDC 'Split Type': WAES0702USA02660
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0640F0IM 
Administered by: Other     Purchased by: Other
Symptoms: Diarrhoea, Rash generalised
SMQs:, Anaphylactic reaction (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow)
Write-up: Information has been received from a nurse practitioner concerning her 17 year old daughter with attention deficit/hyperactivity disorder and a history of shellfish allergy (as a child: outgrew) who in 06-NOV-2006 at 1:00PM, was vaccinated in the left deltoid (previously reported as right deltoid), IM with a first dose of GARDSIL (Lot # 653650/0640F). Her second dose of GARDASIL vaccine (Lot # 653650-0640F) was administered intramuscularly into the right deltoidon 16-January-2007, at 2:00PM. Concomitant therapy included ADDERALL. There was no illness at the time of vaccination. The nurse practitioner reported that 3 days after each dose of GARDSIL vaccine, her daughter developed diarrhea, on 09-NOV-2006 and 19-JAN-2007, respectively. The diarrhea was reported to be "relatively severe and spontaneously resolved" (dates unspecified). On 20-January-2007 at 8:00AM, on the fourth day after the second dose, the patient "developed a rash on her knees and thigh that spread during the day until she was covered in a rash from her neck to her feet." In follow-up, the nurse practitioner confirmed that the patient developed a rash four days post vaccination that covered her legs, trunk, arms and neck. She was treated with BENADRYL and it resolved. The reporter noted that the decision was made to discontinue the series so a third dose would not be given. The patient sought unspecified medical attention. Additional information has been requested. This is in follow-up to report (s) previously submitted on 3/14/2007. Additional information is not expected.

VAERS ID:274284 (history)  Vaccinated:2007-01-23
Age:17.0  Onset:2007-01-23, Days after vaccination: 0
Gender:Female  Submitted:2007-03-14, Days after onset: 49
Location:Unknown  Entered:2007-03-16, Days after submission: 2
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: UNK
Diagnostic Lab Data: temperature measurement 01/23/07 100, temperature measurement 01/23/07 104.8
CDC 'Split Type': WAES0702USA03124
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Body temperature increased, Pharyngolaryngeal pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Information has been received from a nurse concerning a 17 year old female patient with pertinent medical history and drug reactions/allergies reported as unspecified on 23-JAN-2007 was vaccinated with Gardasil (lot # not reported) injection. On an unspecified date, the patient went to the hospital with a sore throat and a fever of 100 degrees. After receiving the Gardasil injection, her temperature went to 104.8 degrees on 23-JAN-2007. The physician administered antibiotics for her sore throat. The outcome of the events was unspecified. Additional information has been requested.

VAERS ID:274328 (history)  Vaccinated:2006-12-04
Age:17.0  Onset:2006-12-04, Days after vaccination: 0
Gender:Female  Submitted:2007-03-14, Days after onset: 99
Location:California  Entered:2007-03-16, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0702USA03841
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0688F1 UN
Administered by: Private     Purchased by: Private
Symptoms: Dizziness, Feeling hot, Hyperhidrosis, Nausea, Pain
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: Information has been received from a health professional concerning a 17 year old female who on 04-DEC-2006 in the PM was vaccinated with a second dose of Gardasil (lot # 653735/0688F), in the left deltoid. There was no concomitant therapy. On 04-DEC-2006 the patient experienced "pain, hot, sweating, dizzy, nauseated." On 14-SEP-2006 the patient was vaccinated with a first dose of Gardasil (yeast). Additional information has been requested.

VAERS ID:274697 (history)  Vaccinated:2007-02-21
Age:17.0  Onset:2007-02-27, Days after vaccination: 6
Gender:Female  Submitted:2007-03-14, Days after onset: 14
Location:Colorado  Entered:2007-03-16, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NYQUIL
Current Illness: Allergic to cats; Food allergy
Preexisting Conditions:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0702USA04286
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.   UN
Administered by: Other     Purchased by: Other
Symptoms: Food allergy, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Information has been received from a nurse practitioner concerning a 17 year old female patient with allergies to cast and scallops who on 21-FEB-2007 was vaccinated with a dose of Gardasil. Concomitant therapy included NYQUIL. 20 hours later, the patient developed hives. Unspecified medical attention was sought. The patient''s hives persisted. The reporter indicated the patient had hives from the vaccine. Additional information has been requested.

VAERS ID:274704 (history)  Vaccinated:2007-02-14
Age:17.0  Onset:2007-02-22, Days after vaccination: 8
Gender:Female  Submitted:2007-03-14, Days after onset: 19
Location:California  Entered:2007-03-16, Days after submission: 2
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: NONE
CDC 'Split Type': WAES0702USA04326
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0014U IM 
Administered by: Other     Purchased by: Other
Symptoms: Axillary mass, Axillary pain
SMQs:
Write-up: Information has been received from a registered nurse concerning a 17 year old female who on 14 Feb 2007 was vaccinated IM in the left deltoid with a 0.5mL dose of Gardasil vaccine. There was no concomitant medication. On 22 Feb 2007 the patient "developed a painful lump underneath the arm pit of the same injection arm". The nurse reported that the patient was told to follow up with the physician as soon as possible. At the time of the report, the patient had not recovered. The patient sought unspecified medical attention. Additional information has been requested.

VAERS ID:274722 (history)  Vaccinated:2006-11-28
Age:17.0  Onset:2006-11-29, Days after vaccination: 1
Gender:Female  Submitted:2007-03-14, Days after onset: 104
Location:New Mexico  Entered:2007-03-16, 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: Unknown
Current Illness:
Preexisting Conditions: Cardiac murmur
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0702USA04640
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0800F0IM 
Administered by: Other     Purchased by: Other
Symptoms: Inappropriate schedule of drug administration, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Information has been received from a Registered Nurse (R.N.) concerning a 17 year old female with a cardiac murmur who on 28-NOV-2006 was vaccinated IM with her first dose of HPV, lot #654540/0800F. On 29-FEB-06 the patient experienced minor soreness around the injection site. The patient did not return for her 2nd dose until 27-FEB-2007. The patient recovered. Additional information has been requested.

VAERS ID:274726 (history)  Vaccinated:2007-01-15
Age:17.0  Onset:2007-01-29, Days after vaccination: 14
Gender:Female  Submitted:2007-03-14, Days after onset: 43
Location:North Carolina  Entered:2007-03-16, Days after submission: 2
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: Unknown records received 5/15/07-seen for repeat chlamydia testing after treatment.
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0702USA04736
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1447F0IMLA
Administered by: Other     Purchased by: Other
Symptoms: Chest discomfort, Chlamydia serology, Complex regional pain syndrome, Paraesthesia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: Initial and follow-up information has been received from a physician concerning a female who was vaccinated with a 0.5 ml dose of Gardasil (lot #655617/1447F). Subsequently, 2 days after vaccination, the patient experienced "RSD reaction" that started in her upper extremities and then moved to her lower extremities. The patient is undergoing a neurology work-up. At the time of the follow-up report, the patient had not recovered. Additional information has been requested. 05/15/07-records received for DOS-1/15/07-seen for repeat chlamydia testing after treatment. C/O episodes of chest tightness without SOB and is worried about pulmonary embolus after reading about this risk on the internet. NuvaRing prescribed. Letter from parent included in notes-per parent. patient had thrid in a series of 3 shots of B12 on 4/16. Developed paresthesia in arm and fingers curled into her palm. Contacted neurologist who referred her to ER, treated with bendaryl and morphine and her arm straightened. Also previously seeing a physical therapist.

VAERS ID:274733 (history)  Vaccinated:2007-02-28
Age:17.0  Onset:2007-02-28, Days after vaccination: 0
Gender:Female  Submitted:2007-03-14, Days after onset: 13
Location:California  Entered:2007-03-16, 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: Acne; Dyspepsia
Preexisting Conditions: Acne; Dyspepsia
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0703USA00085
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0012U0IM 
Administered by: Other     Purchased by: Other
Symptoms: Agitation, Dizziness, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Vestibular disorders (broad)
Write-up: Information has been received from a health professional concerning a 17 year old female patient with history of acne and dyspepsia who on 28-FEB-2007 was vaccinated IM with her first dose of Gardasil lot #655503/0012U. Concomitant therapy included PREVACID, RETIN-A and CLEOCIN. The patient reported that she felt dizzy, nauseated and agitated starting 30 minutes after receiving the infection. The physician advised the patient to rest, monitor symptoms and call the office if no improvement. The patient''s outcome was unknown. Additional information has been requested. Intial and follow-up information has been recieved from a health professional concerning a 17 year old female patient with history of acne and dyspeaio who was vaccinated on 28-Feb-2007 at 12:10am in to left deltoid IM with her first dose 0.5mL of GRADASIL, lot #655503/00120. COncomitant therapy included lansoprazole, trtinoin and clindamycin. On 28-FEB-2007 at 12:40AM the patient reported that she felt dizzy, bnauseated and agitated starting 30 minutes after recieving the injection. Yhe patient was lightheaded for approximately 6 hours. The physician advised the patient to rest, monitor symptoms and call the office if no improvement. The patoent''s outcome was unknown. in follow-up it was reported that patient recoveredon 28-FEB-2007. Additional information is not expected.

VAERS ID:274273 (history)  Vaccinated:2007-03-16
Age:17.0  Onset:2007-03-16, Days after vaccination: 0
Gender:Female  Submitted:2007-03-18, Days after onset: 2
Location:North Dakota  Entered:2007-03-19, 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: Ortho Lo birth control
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1161F0 LA
Administered by: Private     Purchased by: Private
Symptoms: Asthenia, Dizziness, Feeling cold, Feeling hot, 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), 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 (broad)
Write-up: Approx 20 min after vaccine pt felt dizzy, weak and blacked out. Caught by mother before falling to ground. Also felt hot. Taken home (was at grocery store). Felt slightly weak and then at 9 pm that night felt very cold and weak at 9pm. No rxn at injection site.

VAERS ID:274425 (history)  Vaccinated:2007-02-16
Age:17.0  Onset:2007-02-16, Days after vaccination: 0
Gender:Female  Submitted:2007-03-20, Days after onset: 31
Location:Virginia  Entered:2007-03-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: none reported ~~NULL~~In Patient|none reported ~~NULL~~In Sibling1
Other Medications: none
Current Illness: No illness
Preexisting Conditions: Pregnant
Diagnostic Lab Data: none
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAMAHBVB287BA0IMRA
TTOX: TETANUS TOXOID, ADSORBED (NO BRAND NAME)AVENTIS PASTEURU1704CA0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Incorrect dose administered, Pregnancy
SMQs:, Normal pregnancy conditions and outcomes (narrow)
Write-up: Pregnant adolescent in need of immunizations required for school entry (Hepatitis B and Td). Vaccines provided in prenatal clinic without adverse event, but Hep B vaccine was an adult formulation rather than the indicated pediatric version.

VAERS ID:274468 (history)  Vaccinated:2007-03-14
Age:17.0  Onset:2007-03-15, Days after vaccination: 1
Gender:Female  Submitted:2007-03-16, Days after onset: 1
Location:Illinois  Entered:2007-03-21, 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: Advair PRN
Current Illness: NONE
Preexisting Conditions: Asthma, Seasonal allergies (dogs and horses per mom)
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0243V0 LA
Administered by: Private     Purchased by: Private
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Hives on arm (not at injection site) on hands and feet-resolving.

VAERS ID:274560 (history)  Vaccinated:0000-00-00
Age:17.0  Onset:0000-00-00
Gender:Female  Submitted:2007-03-22
Location:California  Entered:2007-03-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: No~~NULL~~In Patient|No~~NULL~~In Sibling1|No~~NULL~~In Sibling2
Other Medications: No
Current Illness: On menses. No known illness
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0954F0IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)AVENTIS PASTEURU1920AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Disturbance in attention, Dizziness, Headache
SMQs:, Anticholinergic syndrome (broad), Noninfectious encephalopathy/delirium (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad)
Write-up: Pt reported that approximately 24hrs after receiving the vaccinations she had a headache, dizziness. Went home, took shower, slept through the night. The next day she didn''t remember much of the previous day. Feels she continues to have trouble absorbing subjects at school. Feels she is gradually getting better.

VAERS ID:274631 (history)  Vaccinated:2007-03-22
Age:17.0  Onset:2007-03-22, Days after vaccination: 0
Gender:Female  Submitted:2007-03-23, Days after onset: 1
Location:Massachusetts  Entered:2007-03-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Orthotricyclen-lo
Current Illness: none T 98.1, patient was seen on 03-14-2007 for viral pharyngitis
Preexisting Conditions: no allergies, dysmenorrhea, H. Pylori 4-2006, mono 4-2006,
Diagnostic Lab Data: N/A
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0188U0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Dizziness
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)
Write-up: Patient had complaints of lightheadedness/dizziness approx. 5-10 minutes after injection. Lasted for approx. 5 minutes. Patient was seated, cold cloth applied to neck and wrists, given water to drink. s/s resolved with intervention and seating. Patient with no other complaints.

VAERS ID:274953 (history)  Vaccinated:2007-03-06
Age:17.0  Onset:2007-03-07, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:Arizona  Entered:2007-03-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Very minimal URI symptoms
Preexisting Conditions:
Diagnostic Lab Data: Done in hospital LP: clear fluid, 1 WBC, 0 RBC, Glucose WNL at 56, protein 19. WBC 16.3, 90% neutrophil. Influenza A and B negative. EEG: mildly abnormal EEG due to excessive presence of beta activity which could be drug related. The lack
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0960F0IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2115AA0IMRA
Administered by: Other     Purchased by: Public
Symptoms: Back pain, Blood culture negative, Body temperature, Bronchitis, C-reactive protein increased, CSF test normal, Convulsion, Culture urine negative, Discomfort, Dizziness, Electroencephalogram abnormal, Fall, Headache, Hyperventilation, Influenza serology negative, Lack of spontaneous speech, Lumbar puncture, Mental status changes, Nuclear magnetic resonance imaging brain, Nystagmus, Pyrexia, Red blood cell sedimentation rate increased, Scan brain, Stridor, Syncope, Tetany, Viral infection
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Convulsions (narrow), Psychosis and psychotic disorders (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (broad)
Write-up: 1:30 Backache, headache, dizziness, generalized discomfort in clinic - call to facility for clarification of side effects, referred to Family Practice - developed stridor, nystagmus - transferred to facility reported at 4:30. Admitted to ICU. Discharged facility 3/9/07. 04/02/07-records received from facility-Fever and altered neurological status. Temp 101.2. Fell at clinic. Fainted. Presented to ER with nystagmus with mainly her gaze toward the right. Not speaking Hyperventilating. Fever a few days ago and had been sick with viral syndrome. PE pupils equal round reactive to light but she had nystagmus frequently every few seconds and mainly seemed with a right. Required interpreter but she had no spontaneous speech. Carpal pedal spasm. Summary for DOS 3/7-3/9/07. DC DX:Diseases disorders of nervous system. Convulsions, Tetany, bronchitis, nystagmus, altered mental status, hyperventilation, headache, lumbago, fever. 8/25/08-progress notes received-3/8/07 all symptoms have resolved discharged without any medications. Continues to experience being a little dizzy when walking.

VAERS ID:274955 (history)  Vaccinated:2007-03-22
Age:17.0  Onset:2007-03-22, Days after vaccination: 0
Gender:Unknown  Submitted:0000-00-00
Location:Pennsylvania  Entered:2007-03-27
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.0088U1IMLA
Administered by: Private     Purchased by: Other
Symptoms: Dizziness, 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), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: Lightheaded then passed out for less than 10 seconds.

VAERS ID:274958 (history)  Vaccinated:2007-03-20
Age:17.0  Onset:2007-03-21, Days after vaccination: 1
Gender:Male  Submitted:2007-03-21, Days after onset: 0
Location:Alabama  Entered:2007-03-27, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Fever/headache/viral infection
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)AVENTIS PASTEURU2228AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Developed rash/welts, urticaria

VAERS ID:274972 (history)  Vaccinated:2007-01-11
Age:17.0  Onset:2007-01-11, Days after vaccination: 0
Gender:Female  Submitted:2007-03-27, Days after onset: 74
Location:New York  Entered:2007-03-27
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: Allergy Penicillin
Diagnostic Lab Data: Chest Xray & EKG within normal limit, Dedimer normal
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1427F0IMRA
Administered by: Private     Purchased by: Private
Symptoms: Chest X-ray normal, Chest pain, Electrocardiogram normal, Fibrin D dimer normal
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)
Write-up: Pt received Gardasil vaccine 1/11/07 at 100PM - Developed c/o chest pain late evening & went to hospital ER. Pt brought this to our attention 3/12/07 when she was scheduled for her second vaccination - dose not given. No intervention other than Advil given in ER.

VAERS ID:275206 (history)  Vaccinated:2007-02-08
Age:17.0  Onset:2007-02-08, Days after vaccination: 0
Gender:Female  Submitted:2007-03-06, Days after onset: 26
Location:Pennsylvania  Entered:2007-03-29, 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:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALSAHABB068BB0IMRA
Administered by: Public     Purchased by: Public
Symptoms: Inappropriate schedule of drug administration, No adverse effect
SMQs:
Write-up: 17 yr old administered Twinrix manufacturer recommendation TS age 18 no adverse reaction

VAERS ID:275216 (history)  Vaccinated:2007-03-23
Age:17.0  Onset:2007-03-27, Days after vaccination: 4
Gender:Male  Submitted:2006-03-26, Days after onset: 365
Location:North Carolina  Entered:2007-03-30, Days after submission: 368
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: History of asthma
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU1860AA0IMLA
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURERC2512AC0IDLA
Administered by: Private     Purchased by: Public
Symptoms: Throat irritation, Throat tightness, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow)
Write-up: Approximately 18 hrs after injection of vaccine, client develop initially under skin followed by development of wheals on neck, torso, head and face right side. Later develop throat irritation and tightness. Has been on Benadryl since Saturday night. Remains on 25 mg Benadryl with decreased free of doses each day.

VAERS ID:275251 (history)  Vaccinated:2007-03-15
Age:17.0  Onset:2007-03-15, Days after vaccination: 0
Gender:Female  Submitted:2007-03-29, Days after onset: 14
Location:California  Entered:2007-03-30, 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: Unknown
Current Illness:
Preexisting Conditions: Unknown. 7/7/2009 Neuro consult received. (+) PPD age 5. OCs.
Diagnostic Lab Data: Unknown. 7/7/2009 Neuro consult received. Labs and Diagnostics: EEG abnormal. MRI brain WNL.
CDC 'Split Type': WAES0703USA03961
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0011U0IM 
Administered by: Other     Purchased by: Other
Symptoms: Activities of daily living impaired, Dyskinesia, Electroencephalogram abnormal, Extensor plantar response, Headache, Injected limb mobility decreased, Muscle twitching, Musculoskeletal pain, Musculoskeletal stiffness, Myalgia, Myoclonus, Neck pain, Nuclear magnetic resonance imaging normal, Pain in extremity, Vision blurred
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Dyskinesia (narrow), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Arthritis (broad)
Write-up: Initial and follow-up information has been received from a Medical Assistant concerning a 17 year old female patient who on 15-MAR-2007 was vaccinated IM with her first dose of Gardasil, lot #654702/0011U. The reporter reported soon after the injection "her arm hurt really bad" and was stiff. On 16-MAR-2007 the patient developed sporadic twitching of her whole body. The reporter stated that the patient "looked as if she had Tourette syndrome. " On 17-MAR-2007 the patient was examined in the emergency room and was released a few hours later. She was examined by her primary physician and gynecologist. She had an appointment with a neurologist. She has not had any improvement in her symptoms of sporadic twitching, however arm pain and stiffness were subsiding. The reporter considered the events to be disabling because the patient was unable to perform her activities of daily living for a week. Additional information has been requested. 7/7/2009 Neuro consult received for 3/20/07-4/13/07 with DX: Intermittent myoclonus. Pt presented for consult after developing twitching in the L leg and shoulder which developed on 3/16/07, one day after receiving HPV vax in R deltoid. Pt also c/o shoulder pain and RUE pain making it difficult to use the R arm. Pt c/o increasing frontal H/A since that time as well. Plantar responses were flexor on the right and extensor on the left. Intermittent jerky movement mostly upper part of body toward left shoulder and rarely in the legs. F/U 3/30/07 with continued H/A and blurred vision but improvement in twitching. RUE pain improved, but now sharp pain in top of neck. Tx with Naproxen which was later d/c due to epigastric pain. Topamax started. 7/14/09 PCP records recd. Seen 3/19/07 for dx: motor twitching. See neuro records. 7/17/09 ER records received DOS 3/17/07 to 3/18/07. Assessment: Shoulder Twitching. Patient presented with sudden onset left shoulder twitching (intermittent). Left shoulder muscle pain. Ativan prescribed, symptom improved, and patient discharged.

VAERS ID:275390 (history)  Vaccinated:2007-02-09
Age:17.0  Onset:0000-00-00
Gender:Male  Submitted:2007-03-06
Location:Pennsylvania  Entered:2007-04-02, Days after submission: 26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None - child well
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (FOREIGN)MERCK & CO. INC.0758F0IMLA
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURY10320SCLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0807F0SCLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1306F0SCRA
Administered by: Public     Purchased by: Public
Symptoms: Erythema, Fatigue, Fluid retention, Pruritus, Pyrexia, Skin irritation, Skin lesion
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Child had vaccinations at health department on 2/9/07. Child presented with raised lesions 1-2 weeks after vaccinations. Lesions are fluid filled, red, irritated and itchy. Child has been fatigued since onset of lesions, no fever noted. Number of lesions has increase to 30-50 now, which are located "all over" childs body. RN advised parent to take child to PCP for assessment.

VAERS ID:275622 (history)  Vaccinated:2007-02-21
Age:17.0  Onset:2007-02-22, Days after vaccination: 1
Gender:Female  Submitted:2007-04-04, Days after onset: 40
Location:Arizona  Entered:2007-04-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Minocycline, Dafferin gel
Current Illness: U.T.I.
Preexisting Conditions: None
Diagnostic Lab Data: Dr examined referred to PT and neurology consult.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.1209F1IMLA
HPV4: HPV (GARDASIL)MERCK & CO. INC.0263U0IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)AVENTIS PASTEURU2209AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Asthenia, Hypotonia, Muscular weakness, Neurological examination, Pain in extremity, Physiotherapy, Urinary tract infection, Urine analysis abnormal
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: Pt c/o pain and weakness in Lt arm persistent since admin. of vaccine in Lt arm. Dr notes pt has decrease muscle strength in Lt arm unable to make a fist and decrease tone in Lt arm. 4/10/07 Received medical records from PCP which include vax records & reveal that on day of vax patient experienced UTI s/s, UA was done & patient started on antibiotics. Returned to PCP on 4/4/07 w/complaints of left arm weakness since vax. Exam revealed decreased left arm muscle strength. Patient was unable to make a fist w/left hand & had decreased muscle tone in left arm. Received neuro & PT referrals.

VAERS ID:275641 (history)  Vaccinated:2007-03-20
Age:17.0  Onset:2007-03-20, Days after vaccination: 0
Gender:Female  Submitted:2007-04-04, Days after onset: 15
Location:Michigan  Entered:2007-04-05, 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: none
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)AVENTIS PASTEURU2003AA0 LA
Administered by: Other     Purchased by: Private
Symptoms: Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Patients other contacted school nurse the morning after shot. Child had "fever 101 deg and body aches". "Lasted into next day". Mother took patient to PCP doctor, no treatment.

VAERS ID:275642 (history)  Vaccinated:2007-01-22
Age:17.0  Onset:2007-01-26, Days after vaccination: 4
Gender:Male  Submitted:2007-03-28, Days after onset: 60
Location:Georga  Entered:2007-04-05, 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:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
BCG: BCG (MYCOBAX)AVENTIS PASTEURC250A0 RA
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS0105F2IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)AVENTIS PASTEURU1874AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: urticaria

VAERS ID:275819 (history)  Vaccinated:2007-03-30
Age:17.0  Onset:2007-04-01, Days after vaccination: 2
Gender:Female  Submitted:2007-04-02, Days after onset: 1
Location:North Carolina  Entered:2007-04-09, 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: none
Current Illness: none
Preexisting Conditions: obesity
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.1213F0IMLA
HPV4: HPV (GARDASIL)MERCK & CO. INC.0960F0IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)AVENTIS PASTEUR 0IMRA
Administered by: Private     Purchased by: Public
Symptoms: Injection site erythema, Injection site induration
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: 5cc of erythema/induration right u pper arm. Claritin, cool compresses.

VAERS ID:275824 (history)  Vaccinated:2007-04-03
Age:17.0  Onset:2007-04-03, Days after vaccination: 0
Gender:Female  Submitted:2007-04-03, Days after onset: 0
Location:Florida  Entered:2007-04-09, 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:
Current Illness: None
Preexisting Conditions: None did have PPD planted after vaccine given.
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)AVENTIS PASTEURU1995AA0IMRA
Administered by: Public     Purchased by: Public
Symptoms: Head banging, Muscle rigidity, Unresponsive to stimuli
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Client presented health department for Menactra immunization and PPD, given 1 hour apart; following PPD, summoned to waiting room to assist; client reclined in chair not responding to name; breathing without difficulty; client''s extremities became rigid; hyper-extended head and repeatedly thrust head against wall; episode lasted approximately 5-8 seconds followed by 10-15 seconds of semi-conscious responses; after episode, client able to sip small amounts of water and respond appropriately to questions; client escorted, via wheelchair, to exam room to rest while awaiting transportation to local ER for evaluation.

VAERS ID:275829 (history)  Vaccinated:2007-04-04
Age:17.0  Onset:2007-04-04, Days after vaccination: 0
Gender:Female  Submitted:2007-04-04, Days after onset: 0
Location:Florida  Entered:2007-04-09, 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: None/NKDA
Diagnostic Lab Data: Blood Glucose (normal)
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0188U0IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)AVENTIS PASTEURU1932AB0IMRA
Administered by: Private     Purchased by: Private
Symptoms: Blood glucose normal, Dizziness, Fatigue, Gait disturbance, Hypotension, Pallor, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Dizziness, pt stated that she was feeling tired, faint, could not walk, almost passed, pale face, low blood pressure. But she was conscious the whole time. The whole episode happened about 10 minutes after receiving the vaccines. She was monitored in the office until she was feeling better. She walked out of the office at 1230 PM. Received the shots at 1140.

VAERS ID:275835 (history)  Vaccinated:2007-02-05
Age:17.0  Onset:2007-02-05, Days after vaccination: 0
Gender:Female  Submitted:2007-04-02, Days after onset: 55
Location:Utah  Entered:2007-04-09, 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:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: Stool cultures and CBC were completed, the results were not available
CDC 'Split Type': 200700799
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2002A0IN 
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Condition aggravated, Cough, Culture stool, Diarrhoea, Full blood count, Headache, Myalgia, Pharyngitis, Rash generalised, Rash papular
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Agranulocytosis (broad), Pseudomembranous colitis (broad), Oropharyngeal infections (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow)
Write-up: Initial report received from a health care professional in the USA on 15, March 2007. A 17 year old female patient developed joint and muscle pain, diarrhea and an erythematous papular full body rash, within 12 hours after she received Menactra (lot # U2002AC) intramuscularly in the deltoid on 05, February 2007. She was seen and evaluated by a doctor on 14, March 2007. Stool cultures and CBC were completed, the results were not available. At the time of the report, the symptoms still persist and the patient was not recovered. This case has the same reporter as case 2007-00798. Follow up information received on 22 June 2007 from a health care professional. Illness at the time of vaccinaiton included myalgia, pharyngitis, cough and headaches. The patient had also been exposed to viral meningitis. She did not follow up for the CBC and stool cultures. In return visits on 09 February 2007, 17 March 2007, and 21 May 2007 (all for pharyngitis), the patient did not complain of symptom due to the immunization. However, in a conversation with the patient''s mother on 05 June 2007, the patient stated that "she still has joint pain in her knees and rash off and on." This case has th esame reporter as 2007-00708.

VAERS ID:276129 (history)  Vaccinated:2007-02-26
Age:17.0  Onset:2007-02-26, Days after vaccination: 0
Gender:Female  Submitted:2007-04-06, Days after onset: 38
Location:South Carolina  Entered:2007-04-09, 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:
Current Illness: Nervousness; hypersensitivity
Preexisting Conditions: Nervousness
Diagnostic Lab Data: Blood pressure, 124/8 mmHg; total hertbeat count, 80, thready
CDC 'Split Type': WAES0703USA00461
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  IMUN
Administered by: Other     Purchased by: Other
Symptoms: Condition aggravated, Crying, Dizziness, Fear, Nervousness, Pulse abnormal, Somnolence, Syncope, Urinary incontinence
SMQs:, Torsade de pointes/QT prolongation (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: This is in follow-up to repor (s) previously submitted on 4/6/2007. Information has been received from a physician via a company representative concerning a "very nervous" 17 year old female who on approximately 26, Feb 2007 ("earlier this week") was vaccinated IM with a 0.5 mL dose of HPV rL1 6 11 16 18 VLP vaccine (yeast) (lot # not reported). On approximately 26, Feb 2007 ("after injection") the patient fainted. The patient sought unspecified medical attention and was reported as recovered (date not specified). Additional information has been requested. In follow-up it was reported by a registered nurse concerning a "very nervous", 17 year old, female, student, with allergy to codine and no illness at the time of vaccination, whose reported weight was 123 pounds who on 26-FEB-2007 was vaccinated intramuscularly (IM) into the left deltoid muscle with a 0.5 ml dose of GARDASIL (Lot # ''02634''). It was reported that the patient had a dizzy feeling and then had a fainting episode. the patient did not fal, she was in a chair and her mother caught her. The nurse stepped out to get the patient water because the patient asked for some. The patient "wet pants" and the patient "came around with ammonia". Her pulse and blood pressure were okay. The patient was crying afterwards and scared. The patient was put on a bed "with head up to elevate her head". The tow physicians saw the patient in the office. The patient recovered and was released to her mother. On 27-FEB-2007, a phone call was placed to the patient''s home. The patient''s mother reported that the patient slept all afternoon and into the night. She ate dinner and had breakfast and went to school. The nurse told the patient''s mother to call a or two before the next appointment to get a prescription for VALIUM, 20 mg and instructed to have the patient take the medication 20-30- minutes before the next appointment.

VAERS ID:276220 (history)  Vaccinated:2007-03-06
Age:17.0  Onset:2007-03-06, Days after vaccination: 0
Gender:Female  Submitted:2007-04-06, Days after onset: 30
Location:South Carolina  Entered:2007-04-09, Days after submission: 3
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: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0703USA01156
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1447F1UNLL
Administered by: Private     Purchased by: Other
Symptoms: Blood pressure increased, Headache, Loss of consciousness, Neurological examination normal, Syncope, Tooth injury
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), Accidents and injuries (narrow), Hypertension (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: This is in follow-up to report(s) previously submitted on 4/6/2007. Information has been received from a nurse concerning a 17 year old female who on 06-MAR-2007 was vaccinated in the higher anterolateral area of the left thigh with a 0.5 mL second dose of GARDASIL (lot 655617/1447F). At the time of vaccination, the patient was alert and good spirits. The nurse did not notice any bleeding after the injection, but she placed a small bandaid at the injection site. The nurse asked the patient if she was okay, and the patient replied "yes". The patient walked to the check out counter and stated that she had a headache and was rubbing her head. The patient was advised to sit down for 15-20 minutes after the GARDASIL was administered but refused to be seated to passing out. The patient''s blood pressure was slightly elevated while she passed out. The nurse was called to the waiting room after the patient fainted. Neurologic check grossly intact. One tooth was bleeding. The patient was taken to the emergency room and checked in. When the patient''s father arrived, the patient stated that she did not want to stay. The father asked if patient was okay. The nurse informed him that she was okay, but the physician thought the patient should be evaluated at the emergency room. The patient''s father refused treatment. At the time of this report, the outcome was unknown. No additional information is expected.

VAERS ID:276228 (history)  Vaccinated:2007-03-07
Age:17.0  Onset:2007-03-07, Days after vaccination: 0
Gender:Female  Submitted:2007-04-06, Days after onset: 29
Location:Florida  Entered:2007-04-09, 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: hormonal contraceptives
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0703USA01294
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0800F1IMLA
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 Registered Nurse (R.N.) concerning a 17 year old female patient who on 10-JAN-2007 was vaccinated with her first dose of Gardasil. On 03-MAR-2007 she was vaccinated IM in her left deltoid with her second dose of Gardasil, lot #654540/0800F. Concomitant therapy included oral contraceptives (unspecified). Shortly after the administration of her second dose,

VAERS ID:276230 (history)  Vaccinated:0000-00-00
Age:17.0  Onset:0000-00-00
Gender:Female  Submitted:2007-04-06
Location:Unknown  Entered:2007-04-09, 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:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0703USA01306
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0 UN
Administered by: Other     Purchased by: Other
Symptoms: Dizziness, Immediate post-injection reaction, Injection site irritation, Injection site pain, Presyncope
SMQs:, Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow)
Write-up: Information has been received from a physician concerning a 17 year old female who was vaccinated with Gardasil first dose. Concomitant therapy included diphtheria toxoid (+) pertussis acellular vaccine (unspecified) (+) tetanus toxoid administered right before Gardasil. The patient said that while she was being administered the Gartdasil (also reported as immediately after receiving Gardasil, she had stinging and burning sensation (at injection site) and felt as if she was going to faint or pass out. The feeling lasted for approximately fifteen minutes. Thereafter, she felt "okay" Subsequently, the patient recovered. Additional information has been requested.

VAERS ID:276240 (history)  Vaccinated:2007-02-28
Age:17.0  Onset:2007-03-01, Days after vaccination: 1
Gender:Female  Submitted:2007-04-06, Days after onset: 35
Location:New York  Entered:2007-04-09, 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:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0703USA01943
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0960F0UNLA
Administered by: Private     Purchased by: Public
Symptoms: Diarrhoea, Dizziness, Eye haemorrhage, Fatigue, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Retinal disorders (broad), Vestibular disorders (broad), Noninfectious diarrhoea (narrow)
Write-up: This is in follow-up to report(s) previously submitted on 4/6/2007. Initial and follow up information has been received from an office receptionist and a nurse practitioner(N.P.) concerning her 17 year old step daughter who on 28-FEB-2007, at 2:30 PM was vaccinated in the left arm with a first dose of GARDASIL lot #654535/0960F. The patient experienced extreme nausea, diarrhea and dizziness after the injection. "Patient was vomiting so hard, that the blood vessels in her eyes broke." The patient''s outcome was unknown. In follow-up it was indicated that patient started vomiting on 01-MAR-2007 at 03:00 AM and vomited 8 times. She broke blood vessels in both eyes. Her diarrhea continued for 24 hours and she was very tired, slept a lot and missed 2 days of school. On 03-MAR-2007 patient recovered. Additional information is not expected.

VAERS ID:275936 (history)  Vaccinated:2007-03-05
Age:17.0  Onset:2007-03-27, Days after vaccination: 22
Gender:Male  Submitted:2007-04-10, Days after onset: 14
Location:California  Entered:2007-04-10
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 records received 5/15/07-HX of URI three weeks prior to admission with fever, cough runny nose and body aches.
Preexisting Conditions: ADHD, migraines
Diagnostic Lab Data: Head CT/MRI, LP, Nerve conduction studies, Blood work records received 5/15/07-CT, MRI and nerve condustion studies were normal at admssion. CSF normal. HIV, CMV and lyme disease negative. GQ1B 1 to 3,200 with reference between 1 to 100 su
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2002AC0IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC2631AA0IDLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Asthenia, Blood test, Borrelia burgdorferi serology negative, CSF test normal, Computerised tomogram, Computerised tomogram normal, Cytomegalovirus test negative, Diplopia, Encephalopathy, Facial palsy, Guillain-Barre syndrome, HIV test negative, Lumbar puncture, Miller Fisher syndrome, Muscular weakness, Nerve conduction studies, Nerve conduction studies normal, Nuclear magnetic resonance imaging, Nuclear magnetic resonance imaging brain normal, Paraesthesia, Urinary retention, Vision blurred
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Glaucoma (broad), Demyelination (narrow), Lens disorders (broad), Retinal disorders (broad), Ocular motility disorders (narrow), Chronic kidney disease (broad)
Write-up: Guillain Barre Syndrome 05/15/07-records received from facility for DOS 3/26-4/9/07-DC DX: Probably Guillain Barre Syndrome. IVIg therapy. Admitted with ascending motor weakness, paresthesias and diplopia three days prior to admission. Right facial droop, urinary retention lethargy and mild encephalopathy. HX of traveling across country. Onset of symptoms sudden progressive blurry vision then weakness in bilateral lower extremities with tingling sensations in hands and feet.

VAERS ID:275999 (history)  Vaccinated:2007-03-20
Age:17.0  Onset:2007-03-22, Days after vaccination: 2
Gender:Female  Submitted:2007-04-06, Days after onset: 15
Location:Unknown  Entered:2007-04-11, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Celexa, Tenex, Lamictal, Depo-provera, susequad
Current Illness:
Preexisting Conditions: Her medical history includes a long psychiatric history with anxiety and panic disorder, posttraumatic stress disorder and attachment disorder. No known medication allergies. The family history is not known. She is adopted. She has been adopted since age 5. No history of alcohol or tobacco. Records received 5/16/07- HX of anxiety, panic disorder, post traumatic stress disorder. H
Diagnostic Lab Data: Her blood pressure is 118/79, temperature 36.7, pulse 81 and respirations 22. HEAD, EARS, EYES, NOSE AND THROAT Unremarkable. Conjunctivae are pink. Buccal mucosa are moist. No cervical lymphadenopathy. Thyroid not palpable. CHEST Clear to
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  IM 
Administered by: Other     Purchased by: Other
Symptoms: Abdominal pain, Blood pressure normal, Body temperature, Cardiac murmur, Gastritis, Gastrooesophageal reflux disease, Heart rate normal, Mental disorder, Nausea, Ultrasound scan normal, Vomiting
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Gastrointestinal nonspecific inflammation (narrow), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: A 17-year-old female who was brought to the emergency room because of progressively worsening right-sided abdominal pain since the day before her admission. She developed some nausea and had emesis in the emergency room. No previous history of abdominal pain. Additionally, she had received an injection of Gardasil three to four days prior to onset of these symptoms. She has no fever and no chills, No chest pain. Nausea and vomiting, as stated. No diarrhea. She did have a normal bowel movement yesterday. Her periods had been regular until she was started on Depo-Provera. No fever. No chills. No significant weight changes. No history of diabetes. Mental health problems as stated earlier. 05/16/07-records received for DOS 3/22-3/30/07;DC DX:Abdominal pain, question etiology. Possible GE reflux disease. Gastritis. post traumatic stress disorder. Question biliary colic. Dilated common bile duct, possibly normal variant. Admitted from ED with worsening right sided abdominal pain. Nausea and emesis. No fevers,

VAERS ID:276009 (history)  Vaccinated:2007-03-21
Age:17.0  Onset:2007-03-22, Days after vaccination: 1
Gender:Male  Submitted:2007-04-02, Days after onset: 11
Location:Virginia  Entered:2007-04-11, 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: Trazadone
Current Illness: none before vaccine
Preexisting Conditions: None
Diagnostic Lab Data: Rapid flu test=Neg for influenza
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)AVENTIS PASTEURC2406AA0IMRA
Administered by: Other     Purchased by: Public
Symptoms: Body temperature increased, Headache, Influenza serology negative, Injection site erythema, Injection site nodule, Pain, Pain in extremity
SMQs:, Neuroleptic malignant syndrome (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Pt states arm was sore on evening of 3/21/07. On 3/22/07 early am-severe arm pain prescribed with Ibuprofen. At 11am on 3/22/07 pt presented with ''Body Aches All Over", T=100.6 and headache. Prescribed with Ibuprofen. Right deltoid had 4 mm diam. erythema with 1 mm central nodule. Rapid flu test-NEG. By evening of 3/22/07 pt was "well" Pt states Hep A shots (8/30/06 + 3/5/07) give him only sore arm.

VAERS ID:276013 (history)  Vaccinated:2007-03-13
Age:17.0  Onset:2007-03-13, Days after vaccination: 0
Gender:Female  Submitted:2007-04-04, Days after onset: 22
Location:Oregon  Entered:2007-04-11, 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: Effexor XR 150 mg; Lexapro 10 mg; Ortho Evra Patch
Current Illness: None
Preexisting Conditions: Allergy Augmentin and Penicillin
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1426F0IMRA
Administered by: Private     Purchased by: Public
Symptoms: Pyrexia, Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: Moderate Fever, widespread rash/hives

VAERS ID:276047 (history)  Vaccinated:2007-04-04
Age:17.0  Onset:2007-04-04, Days after vaccination: 0
Gender:Male  Submitted:2007-04-11, Days after onset: 7
Location:New Jersey  Entered:2007-04-11
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: EKG: V2-6 ST ELEVATION. ELEVATED TNI. NORMAL ECHO. ACUTE VIRAL TITERS PENDING records received 6/5/07-EKG showed ST elevation. Troponin 16.5. CRP 8.1, ESR 59. Urine trace protein. Echocardiogram is normal. Urine drug screen positive for TH
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC2610AA0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: C-reactive protein increased, Drug screen positive, Electrocardiogram ST segment elevation, Electrocardiogram abnormal, Myocarditis, Pleuritic pain, Protein urine present, Pyrexia, Rash macular, Red blood cell sedimentation rate increased, Troponin I increased, Viral test
SMQs:, Acute renal failure (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Drug abuse and dependence (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Hypersensitivity (narrow)
Write-up: PLEURITIC CHEST PAIN, MACULAR CHEST RASH 45 MIN. TO ONE HOUR AFTER ADM. OF Tdap (ADACEL). TREATED IN ED WITH NEBULIZED LEVALBUTEROL AND DIPHENHYDRAMINE WITH RESOLUTION OF SYMPTOMS; PREDNISONE TABLETS Records received 4/24/07-Admitted with 3 day history of fever and chest pain. Chest pain localized, central and stabbing began shortly after receiving DTaP. 06/05/07-DC summary received from facility for DOS 4/4-4/6/07-DC DX: Idiopathic myocarditis temporally related to TDaP administration. No associated pericardial effusion, cardiac dysfunction or arrhythmia.

VAERS ID:276277 (history)  Vaccinated:2007-04-04
Age:17.0  Onset:2007-04-04, Days after vaccination: 0
Gender:Male  Submitted:2007-04-13, Days after onset: 9
Location:Indiana  Entered:2007-04-13
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: allergies
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2142AA0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Body temperature increased, Dizziness, Erythema, Injection site swelling, Myalgia, Nausea, Pain, Swelling
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (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), Vestibular disorders (broad), Hypersensitivity (broad)
Write-up: Menactra given 04/04/2007. Later that evening the patient devvelped a temp of 101, had nausea and felt lightheaded. Left arm was red and swollen and he states that every muscle in his body hurt. On 4/5/07 patient was seen by family physician. Was given Rx of Keflex and continued on routine medications, Allegra and Singular. Continued with lightheadedness and muscle aches until 4/8/07. On 4/9/07 muscle aches did decrease.

VAERS ID:276289 (history)  Vaccinated:2007-04-11
Age:17.0  Onset:2007-04-11, Days after vaccination: 0
Gender:Female  Submitted:2007-04-14, Days after onset: 3
Location:Colorado  Entered:2007-04-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Nexium
Current Illness: Acid Reflux
Preexisting Conditions: Migrains
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPVX: HPV (NO BRAND NAME)UNKNOWN MANUFACTURER 0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Muscle spasms, Pain, Pelvic pain
SMQs:, Dystonia (broad)
Write-up: 4/11/07 @3:10pm - patient went to the doctor for pain in stomache, diagnosed as Acid Reflux. We were given a flyer fo HPV, and we all agreed that patient needed to recieve the vaccine. Approximately 3 hours after that, patient complained of cramping in her pelvic area (right, left, and middle of her pany-line area). She took 1-600mg Ibuprophin, which eased the pain. She still complains of pain in that area today. I called the nurse who gave the vaccine, and she said this was not a symptom. Just thought I''d write what we have experienced after recieving the HPV vaccine.

VAERS ID:276422 (history)  Vaccinated:2007-04-13
Age:17.0  Onset:2007-04-13, Days after vaccination: 0
Gender:Female  Submitted:2007-04-16, Days after onset: 3
Location:North Carolina  Entered:2007-04-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None but she has fainted before while receiving vaccines but had never had a convulsion. The same thing happenned to her friend
Preexisting Conditions:
Diagnostic Lab Data: Doctor recommended and EKG. We are still pending on this.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPVX: HPV (NO BRAND NAME)UNKNOWN MANUFACTURER 0  
MMR: MEASLES + MUMPS + RUBELLA (VIRIVAC)MERCK & CO. INC. 2  
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)AVENTIS PASTEUR 0  
Administered by: Private     Purchased by: Unknown
Symptoms: Convulsion, Eye rolling, Musculoskeletal stiffness, Screaming, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Cardiomyopathy (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Arthritis (broad)
Write-up: Sindy fainted and had a convulsion/seizure immediately after receiving the first HPV shot. While she was out, she suddenly lifted her upper body, rolled her eyes, made a screeching noise (like scared) and stiffed her hands.

VAERS ID:276641 (history)  Vaccinated:2007-01-16
Age:17.0  Onset:2007-01-16, Days after vaccination: 0
Gender:Female  Submitted:2007-04-13, Days after onset: 86
Location:New York  Entered:2007-04-16, 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: Hormonal contraceptives
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0702USA01030
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1427F0IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Pain in extremity, Sensation of heaviness
SMQs:
Write-up: Information has been received from a nurse practitioner concerning a 17 year old female patient who was vaccinated with Gardasil (lot# 655619/1427F) (0.5 ml), intramuscularly in the deltoid. Concomitant therapy included birth control pills. Subsequently the patient complained of heaviness and pain in left arm. The patient outcome was reported as recovered. No product quality complaint was involved.

VAERS ID:276686 (history)  Vaccinated:0000-00-00
Age:17.0  Onset:0000-00-00
Gender:Female  Submitted:2007-04-13
Location:Florida  Entered:2007-04-16, Days after submission: 3
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': WAES0703USA03072
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 1UNUN
Administered by: Other     Purchased by: Other
Symptoms: Injection site bruising
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)
Write-up: Information has been received from a certified medical assistant (CMA) concerning a 17 year old female who was vaccinated with a second dose of Gardasil five week after vaccination with the first dose. Subsequently, the patient developed a "bruise" at the injection site. The patient sought unspecified medical attention. The outcome of the patient''s injection site bruising was unknown. Additional information has been requested.

VAERS ID:276687 (history)  Vaccinated:2007-02-01
Age:17.0  Onset:2007-02-01, Days after vaccination: 0
Gender:Female  Submitted:2007-04-13, Days after onset: 70
Location:Pennsylvania  Entered:2007-04-16, 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:
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type': WAES0703USA03085
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0UNUN
Administered by: Other     Purchased by: Other
Symptoms: Chills, Influenza like illness, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Information has been received from a registered nurse concerning a 17 year old female with no known drug allergies who in February 2007, was vaccinated with the first dose of Gardasil. There was no concomitant medication. In February 2007, "shortly after" vaccination, the patient developed fever, chills and flu-like symptoms. The patient was treated with acetaminophen (TYLENOL). On an unspecified date, the patient recovered from the fever, chills and flu-like symptoms. Additional information has been requested. This is in follow-up to report(s) previously submitted on 4/13/2007. Follow-up information was received from the registered nurse stating that they had no additional information on the case.

VAERS ID:276690 (history)  Vaccinated:2007-03-14
Age:17.0  Onset:2007-03-14, Days after vaccination: 0
Gender:Female  Submitted:2007-04-13, Days after onset: 30
Location:Kentucky  Entered:2007-04-16, Days after submission: 3
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: None
Diagnostic Lab Data: None
CDC 'Split Type': WAES0703USA03133
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0187U0IM 
Administered by: Private     Purchased by: Private
Symptoms: Abdominal pain, Dizziness, Headache
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: Information has been received from a registered nurse concerning a 17 year old female with no pertinent medical history or drug reactions/allergies who on 14-MAR-2007 was vaccinated intramuscularly with the first dose of Gardasil (0.5 ml) (lot # 656049/0187U). Concomitant therapy included Adderall tablets. On approximately 15-MAR-2007, the patient experienced headache and abdominal pain. Unspecified medical attention was sought, At the time of this report, the outcome of the events was unknown. Additional information has been requested. 07/06/07 This is in follow-up to report(s) previously submitted on 4/13/2007. Immediately after the vaccine was administered, the patient felt dizzy and three hours later, the patient experienced abdominal pain. The patient also experienced headache. The dizziness subsided after 30 minutes, and subsequently, the patient recovered from the abdominal pain. Additional information has been requested.

VAERS ID:276802 (history)  Vaccinated:2007-03-15
Age:17.0  Onset:2007-03-15, Days after vaccination: 0
Gender:Female  Submitted:2007-04-13, Days after onset: 29
Location:Massachusetts  Entered:2007-04-16, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: citalopram; trazodone hydrochloride
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0703USA03424
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0UNUN
Administered by: Other     Purchased by: Other
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Information has been received from a physician concerning a 17 year old female patient who on 15-MAR-2007 was vaccinated with the first dose of Gardasil. Concomitant therapy included traxodone HC1 and citalopram. On 15-MAR-2007 the patient experienced generalized hives. Treatment included diphenhydramine HC1 (BENADRYL), and at the time of the report the patient was reported to be recovering. Additional information has been requested.

VAERS ID:276805 (history)  Vaccinated:0000-00-00
Age:17.0  Onset:0000-00-00
Gender:Female  Submitted:2007-04-13
Location:New York  Entered:2007-04-16, Days after submission: 3
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:
CDC 'Split Type': WAES0703USA03461
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  IMUN
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 17 year old female who was vaccinated with Gardasil. Subsequently the patient fainted after being administered the vaccine. As of 16-MAR-2007 the patient was recovering. Additional information has been requested.

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